Allergy Asthma Immunol Res.  2018 Jan;10(1):18-24. 10.4168/aair.2018.10.1.18.

A Retrospective Study of Clinical Response Predictors in Subcutaneous Allergen Immunotherapy With House Dust Mites for Allergic Rhinitis

Affiliations
  • 1Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. ye9007@ajou.ac.kr
  • 2Clinical Trial Center, Ajou University Medical Center, Suwon, Korea.

Abstract

PURPOSE
House dust mites (HDM) are major allergens that cause allergic rhinitis (AR). Allergen-specific subcutaneous immunotherapy (SCIT) has been shown to be clinically beneficial in many clinical trials. Such trials, however, are not reflective of all patient populations. The aim of this study was to describe the efficacy and safety of SCIT in routine clinical practice in Korean adults with AR sensitized to HDM.
METHODS
We reviewed medical records of 304 patients with AR treated at an allergy clinic of a tertiary hospital using SCIT with aluminum hydroxide-adsorbed allergen extract targeting HDM alone or with pollens for at least 1 year from 2000 to 2012. Patients with asthma were excluded. 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. Specific immunoglobulin E (IgE) levels to HDM were categorized into 6 classes.
RESULTS
The mean time until achieving remission was 4.9±0.1 years, and the cumulative incidence of remission from AR was 76.6%. Severe AR (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.23-0.69; P=0.001), specific IgE levels to HDM ≥17.5 kU/L (OR, 1.85; 95% CI, 1.01-3.37; P=0.045), and duration of immunotherapy ≥3 years (OR, 7.37; 95% CI, 3.50-15.51; P<0.001) were identified as significant predictors of clinical remission during SCIT for patients with AR sensitized to HDM. Overall, 73 patients (24.0%) experienced adverse reactions to SCIT, and only 1 case of anaphylaxis (0.3%) developed.
CONCLUSIONS
SCIT with HDM was found to be effective and safe for patients with AR. Specific IgE levels to HDM and a duration of SCIT ≥3 years may be predictors of clinical responses to SCIT in AR patients.

Keyword

Allergen-specific immunotherapy; house dust mites; remission; rhinitis, allergic

MeSH Terms

Adult
Allergens
Aluminum
Anaphylaxis
Asthma
Desensitization, Immunologic*
Dust*
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Immunotherapy
Incidence
Life Tables
Medical Records
Pollen
Pyroglyphidae*
Retrospective Studies*
Rhinitis, Allergic*
Tertiary Care Centers
Allergens
Aluminum
Dust
Immunoglobulin E
Immunoglobulins

Figure

  • Fig. 1 Target allergens and treatment status in patients with AR. AR, allergic rhinitis; HDM, house dust mites.

  • Fig. 2 Remission probability by AIT for patients with AR who were sensitized to HDM only or HDM and pollens. Survival curve and life tables were generated by the Kaplan-Meier method. AIT, allergen-specific immunotherapy; AR, allergic rhinitis; HDM, house dust mites; S.E, standard error; CI, confidence interval.

  • Fig. 3 A significant temporal correlation for total IgE levels over the SCIT period between the remission and non-remission groups of AR patients was indicated in a generalized estimating equation model. Error bars indicate standard error means of total serum IgE levels. IgE, immunoglobulin E; SCIT, subcutaneous immunotherapy; AR, allergic rhinitis. *P<0.05.


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Comparison of Long-term Efficacy of Subcutaneous Immunotherapy in Pediatric and Adult Patients With Allergic Rhinitis
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Allergy Asthma Immunol Res. 2019;11(1):68-78.    doi: 10.4168/aair.2019.11.1.68.

Safety of Ultra-rush Schedule of Subcutaneous Allergen Immunotherapy With House Dust Mite Extract Conducted in an Outpatient Clinic in Patients With Atopic Dermatitis and Allergic Rhinitis
So-Hee Lee, Myoung-Eun Kim, Yoo Seob Shin, Young-Min Ye, Hae-Sim Park, Dong-Ho Nahm
Allergy Asthma Immunol Res. 2019;11(6):846-855.    doi: 10.4168/aair.2019.11.6.846.

Efficacy of Allergen Immunotherapy for Allergic Asthma in Real World Practice
Hyo-In Rhyou, Young-Hee Nam
Allergy Asthma Immunol Res. 2020;12(1):99-109.    doi: 10.4168/aair.2020.12.1.99.

Factors Associated with Adherence to Allergen Specific Subcutaneous Immunotherapy
Ji-Ho Lee, So-Hee Lee, Ga-Young Ban, Young-Min Ye, Dong-Ho Nahm, Hae-Sim Park, Yoo Seob Shin
Yonsei Med J. 2019;60(6):570-577.    doi: 10.3349/ymj.2019.60.6.570.

Tolerogenic Dendritic Cells Reduce Airway Inflammation in a Model of Dust Mite Triggered Allergic Inflammation
Luciana S. Aragão-França, Viviane C. J. Rocha, Andre Cronemberger-Andrade, F. H. B. Costa, José Fernandes Vasconcelos, Daniel Abensur Athanazio, Daniela Nascimento Silva, E. S. Santos, Cássio Santana Meira, C. F. Araújo, Jéssica Vieira Cerqueira, Fabíola Cardillo, Neuza Maria Alcântara-Neves, Milena Botelho Pereira Soares, Lain C. Pontes-de-Carvalho
Allergy Asthma Immunol Res. 2018;10(4):406-419.    doi: 10.4168/aair.2018.10.4.406.


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