Yonsei Med J.  2016 Nov;57(6):1420-1426. 10.3349/ymj.2016.57.6.1420.

Clinical Efficacy of Subcutaneous Allergen Immunotherapy in Patients with Atopic Dermatitis

• Nahm DH
• Kim ME
• Kwon B
• Cho SM
• Ahn A

• KMID: 2427160
• DOI: http://doi.org/10.3349/ymj.2016.57.6.1420

Abstract

PURPOSE
The clinical usefulness of subcutaneous allergen immunotherapy (SCIT) in the treatment of atopic dermatitis (AD) is still controversial. We analyzed the clinical efficacy of SCIT in patients with AD and the clinical characteristics of patients showing a favorable clinical response to the treatment.
MATERIALS AND METHODS
Two hundred and fifty one patients with AD sensitized to house dust mite (HDM) were treated by SCIT using HDM extract. The clinical severity of AD was measured using the standardized clinical severity scoring system for AD (SCORAD) at baseline and 12 months. A favorable clinical response to SCIT was defined as a decrease in SCORAD value at 12 months greater than 50% compared to baseline value. Severe AD was defined as a baseline SCORAD value above 50.
RESULTS
A favorable clinical response to SCIT was observed in 73.6% of patients. The proportion of patients showing a favorable clinical response to SCIT was significantly higher in patients with severe AD (90.6%) than patients with mild to moderated AD (63.7%) (p<0.001). Patients with severe AD showing a favorable clinical response had a significantly shorter duration of AD (12.3±8.5 years; mean±SD) than patients with severe AD showing no significant clinical response (20.6±10.9 years) (p<0.05) at baseline.
CONCLUSION
SCIT could be a clinically useful therapeutic option for patients with severe AD sensitized to HDM. Early initiation of SCIT might provide a favorable clinical outcome in patients with severe AD sensitized to HDM.

Keyword

Dermatitis, atopic; allergens; desensitization; clinical efficacy

MeSH Terms

Adult
Allergens/*administration & dosage
Animals
Dermatitis, Atopic/*immunology/*therapy
Desensitization, Immunologic/*methods
Dust/*immunology
Female
Humans
Injections, Subcutaneous
Male
Middle Aged
Mites/*immunology
Pyroglyphidae/immunology
Reference Standards
Time Factors
Treatment Outcome
Allergens
Dust

Figure

• 

  Fig. 1 Change in clinical severity of atopic dermatitis from baseline to 12 months after subcutaneous allergen immunotherapy with house dust mites extract in patients with atopic dermatitis (n=144) who received allergen immunotherapy with house dust mite extract for 12 months (A), and the degrees of clinical improvements in patients with mild to moderate atopic dermatitis and patients with severe atopic dermatitis who received allergen immunotherapy with house dust mite extract for 12 months, at 12 months compared to baseline (B). Data are expressed as means±standard error of the mean. Clinical severity score was expressing as standardized clinical severity scoring system for atopic dermatitis (SCORAD) value. Severe atopic dermatitis was defined as a baseline SCORAD value above 50.

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