J Korean Med Sci.  2017 Jul;32(7):1124-1130. 10.3346/jkms.2017.32.7.1124.

Subcutaneous Immunotherapy for Allergic Asthma in a Single Center of Korea: Efficacy, Safety, and Clinical Response Predictors

• Lee JH
• Kim SC
• Choi H
• Jung CG
• Ban GY
• Shin YS
• Nahm DH
• Park HS
• Ye YM

• KMID: 2379607
• DOI: http://doi.org/10.3346/jkms.2017.32.7.1124

Abstract

Allergen-specific immunotherapy is the only causal treatment for allergic diseases. However, the efficacy of immunotherapy may vary around the world due to differences in climate, the nature of aero-allergens and their distribution. The aim of this study was to describe the effects of subcutaneous immunotherapy (SCIT) in Korean adults with allergic asthma (AA). As a retrospective cohort study, we reviewed medical records for 627 patients with AA in Korea who were sensitized to house dust mite (HDM) and/or pollens and who underwent SCIT with aluminum hydroxide adsorbed allergen extract from 2000 to 2012. Rates of remission, defined as no further requirement of maintenance medication, over time were determined by means of life tables and extension of survival analysis. Herein, 627 asthmatic patients achieved remission within a mean of 4.7 ± 0.2 years. The cumulative incidence rates of remission from AA were 86.9% upon treatment with SCIT. Baseline forced expiratory volume in the first second (FEV1) ≥ 80% (hazard ratio [HR], 3.10; 95% confidence interval [CI], 1.79-5.39; P < 0.001), and maintenance of immunotherapy for more than 3 years (HR, 1.82; 95% CI, 1.21-2.72; P = 0.004) were significant predictors of asthma remission during SCIT. In 284 patients on SCIT with HDM alone, initial specific immunoglobulin E (IgE) levels to Dermatophagoides pteronyssinus and Dermatophagoides farinae did not show significant difference between remission and non-remission group after adjusting demographic variables. In conclusion, SCIT was effective and safe treatment modality for patients with AA. Initial FEV1 ≥ 80% and immunotherapy more than 3 years were found to be associated with favorable clinical responses to SCIT.

Keyword

Allergen-Specific Immunotherapy; Allergic Asthma; House Dust Mites; Remission

MeSH Terms

Adult
Aluminum Hydroxide
Asthma*
Climate
Cohort Studies
Dermatophagoides farinae
Dermatophagoides pteronyssinus
Forced Expiratory Volume
Humans
Immunoglobulin E
Immunoglobulins
Immunotherapy*
Incidence
Korea*
Life Tables
Medical Records
Pollen
Pyroglyphidae
Retrospective Studies
Aluminum Hydroxide
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1 Target allergen and treatment status for each patient group.AA = allergic asthma, AR = allergic rhinitis, HDM = house dust mite.

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  Fig. 2 Remission probability of AIT for patients with AA over time. Survival curves and life tables were generated by the Kaplan-Meier method. Two-sided P values were calculated using the log-rank test.AIT = allergen-specific immunotherapy, AA = allergic asthma.

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