Clinical study on value and limitations of subcutaneous immunotherapy (specific hyposensitization) in allergic asthma to house dust mite, based on a personal algorithm of selection.

Subcutaneous immunotherapy (SI) was administered to 148 patients (76 males, 72 females; aged 6-48 years) with allergic asthma to house dust and mites (D. pteronyssinus). Skin tests were positive to both allergens. Treatment was performed with allergenic extracts of house dust (61 patients) and allergenic extracts to house dust mites (87 patients) over a period of at least one year (mean 2.8 years). The selection criteria were: past history (including positive natural provocation test), intense skin response to mite extracts (> 10 mm) and favorable response to therapy with disodium cromoglycate and/or ketotifen. None of the patients selected presented long-lasting infections or other complications in the evolution of asthma. During treatment it was necessary in 46% of the patients to add other drugs such as mast cell degranulators or corticosteroid products over short periods when occasional cases of respiratory infections occurred. Favorable results were obtained in 86% of the cases, with the best results being obtained in patients who exactly fulfilled the selection criteria and in whom SI was administered over a period of at least 3 years.