Long-Lasting Effects of Sublingual Immunotherapy for House Dust Mites in Allergic Rhinitis with Bronchial Hyperreactivity: A Long-Term (13-Year) Retrospective Study in Real Life

• Published in: International Archives of Allergy and Immunology Vol. 142; no. 1; pp. 70 - 78
• Main Authors: Marogna, Maurizio, Bruno, Marco, Massolo, Alessandro, Falagiani, Paolo
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2007; S. Karger AG
• Subjects: Administration, Sublingual; Allergies; Animals; Antigens, Dermatophagoides - administration & dosage; Biological and medical sciences; Bronchial Hyperreactivity - etiology; Bronchial Hyperreactivity - therapy; Bronchial Provocation Tests; Clinical trials; Comparative analysis; Dermatophagoides pteronyssinus; Desensitization, Immunologic - methods; Forced Expiratory Volume; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunopathology; Medical sciences; Methacholine Chloride - pharmacology; Original Paper; Pharmacology; Pyroglyphidae - immunology; Respiratory system; Respiratory therapy; Rhinitis, Allergic, Perennial - complications; Rhinitis, Allergic, Perennial - therapy; Severity of Illness Index; Time Factors; Rhinitis; Sublingual immunotherapy; Bronchial reactivity; Immunopathology; Allergy; Nose disease; Desensitization; Hyperreactivity; House dust; Sublingual administration; Bronchus; Mite; Respiratory system; Long term; Retrospective; Respiratory tract; Immunology; Reactivity; ENT disease; Long lasting
• ISSN: 1018-2438; 1423-0097; 1365-2567
• DOI: 10.1159/000096001

Background: Subcutaneous immunotherapy for respiratory allergy has shown a long lasting efficacy after its discontinuation, whereas evidence in the case of sublingual immunotherapy (SLIT) is weak. This retrospective study evaluates whether SLIT exerts a long-lasting effect and whether it relates to its duration. Methods: Sixty-five patients allergic to mite and positive to methacholine challenge 13 years ago were studied. Twelve (control group, SLIT 0) were treated for 4 years only with standard pharmacological therapy (SPT), while 53 received SLIT and SPT. Among these, four groups were identified according to SLIT duration. Fifteen patients were treated for 1 year (SLIT 1), 10 for 2 (SLIT 2), 14 for 3 (SLIT 3) and 14 for 4 years (SLIT 4). Clinical parameters (symptom monthly score, SMS), bronchial reactivity and FEV 1 were evaluated in 1992 (run-in), 1993 (baseline) and every 2 years from 1997 to 2005. Results: Two to 3 years after the treatment ended, a positive effect on SMS, but not methacholine challenge and FEV 1 , was seen in the SLIT groups versus SLIT 0. At this time interval an effect on methacholine challenge was also seen in SLIT 3. After 7–8 years a significant difference was seen for SMS, i.e., it was significantly better in SLIT 4 than in the other groups, while bronchial reactivity was still improved in SLIT 1, 3 and 4 only after 5–6 years. Conclusions:The effects of a 4-year SLIT on clinical parameters but not bronchial reactivity and FEV 1 last 7–8 years after its discontinuation. SLIT shorter than 4 years yields proportionally less impressive results.