Allergy Asthma Immunol Res.  2019 Jan;11(1):68-78. 10.4168/aair.2019.11.1.68.

Comparison of Long-term Efficacy of Subcutaneous Immunotherapy in Pediatric and Adult Patients With Allergic Rhinitis

• Huang Y
• Wang C
• Cao F
• Zhao Y
• Lou H
• Zhang L

• KMID: 2426786
• DOI: http://doi.org/10.4168/aair.2019.11.1.68

Abstract

PURPOSE
Data comparing the long-term efficacy and safety of subcutaneous immunotherapy (SCIT) using house dust mite (HDM) in children and adults with allergic rhinitis (AR) are limited. This study aimed to compare the long-term effects of HDM-SCIT in a cohort of Chinese pediatric and adult patients with AR.
METHODS
A total of 124 pediatric and adult AR patients received HDM-SCIT for 3 years, with 118 patients being followed-up for 2 years. Prior to treatment (baseline), at the end of the 3-year treatment periods (third year) and 2 years after the discontinuation of treatment (fifth year), all patients were evaluated for total nasal symptom scores (TNSS), daily medication score (DMS), total combined score (TCS; symptoms [nasal + ocular] + DMS) and quality of life (QoL). Safety was assessed according to adverse events reported.
RESULTS
After 3-year treatment, HDM-SCIT significantly improved symptoms and QoL scores at the end of the third and fifth years in both groups. Better improvements were observed in the third and fifth years based on baseline, in children compared to adults (TNSSΔ3: 6.66 vs. 5.41, P = 0.011; TCSΔ3: 4.30 vs. 3.83, P = 0.027 and TNSSΔ5: 6.16 vs. 4.86, P = 0.037; TCSΔ5: 4.11 vs. 3.62, P = 0.044).Shorter duration of AR history before SCIT (<10 vs. ≥10 years) resulted in better improvements at the end of the third and fifth years (TCSΔ3: 4.12 vs. 3.13, P = 0.036; TCSΔ5: 3.90 vs. 3.09, P = 0.033). HDM-SCIT was safe and comparable in both children and adults with AR.
CONCLUSIONS
Children with AR may achieve better long-term efficacy of HDM-SCIT than adults with AR.

Keyword

Allergic rhinitis; house dust mite; immunotherapy; subcutaneous; treatment outcome

MeSH Terms

Adult*
Asian Continental Ancestry Group
Child
Cohort Studies
Humans
Immunotherapy*
Pyroglyphidae
Quality of Life
Rhinitis, Allergic*
Treatment Outcome

Figure

• 

  Fig. 1 Comparison of nasal symptoms (A), TNSS, AR/C DSS, DMS, TCS (B), and RQLQ scores (C) at baseline, and in the third and fifth years (2 years after the discontinuation of treatment). All scores were significantly decreased after the 3-year SCIT (P < 0.001). Statistically significant difference could be observed between the 3-year and 5-year SCIT in nasal congestion, discharge, TNSS, AR/C, DSS, DMS and TCS. SCIT, subcutaneous immunotherapy; TNSS, total nasal symptoms scores; AR/C DSS, allergic rhinoconjunctivitis daily symptom scores; DMS, daily medication score; TCS, total combined score; RQLQ, rhinoconjunctivitis quality of life questionnaire. *P < 0.001; †P < 0.01.

• 

  Fig. 2 Comparison of improvements in long-term (3-year and 5-year) efficacy of SCIT in children and adults with AR, assessed as a change in TNSS and TCS from baseline to the third and fifth years. Better improvements in both TNSS and TCS were observed from baseline to the end of the third and fifth years in children compared to adults. SCIT, subcutaneous immunotherapy; AR, allergic rhinitis; TNSS, total nasal symptoms scores; TCS, total combined score. *P < 0.05.

• 

  Fig. 3 Comparison of improvements in TCS from baseline to the end of the third and fifth years in patients with < 10 years history of AR before SCIT and patients with ≥10 years history of AR. TCS, total combined score; AR, allergic rhinitis; SCIT, subcutaneous immunotherapy. *P < 0.05.

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