Ott H, Sieber J, Brehler R, Fölster-Holst R, Kapp A, Klimek L, Pfaar O, Merk H
Department of Dermatology & Allergology, University Hospital of the Rheinisch Westfälische Technische Hochschule Aachen, Germany.
Allergy. 2009 Jan;64(1):179-86. doi: 10.1111/j.1398-9995.2008.01875.x. Epub 2008 Nov 28.
Data supporting a carry-over effect with sublingual immunotherapy (SLIT) are scarce. This randomized, double-blind, placebo-controlled study evaluated the efficacy, carry-over effect and safety of grass pollen SLIT using co-seasonal treatment.
Patients (7.9-64.7 years) with grass pollen allergy received ultra-rush titration with increasing doses (30, 90, 150 and 300 IR) of a 5-grass pollen mixture every 20 min at the start of the pollen seasons, followed by 300 IR daily until the end of the pollen seasons. A baseline season (no SLIT) was followed by three consecutive treatment seasons and one follow-up season. Symptoms, medication and adverse events were documented and specific immunoglobulin (Ig)E and IgG(4) measured.
Data were analysed for 183 of the 213 randomized patients. Mean treatment duration varied between seasons (81.8-92.7 days). Combined scores (symptoms and medication) improved progressively across treatment seasons (up to 44.7% improvement for SLIT compared with baseline) and fluctuated between -11.3% and -14.8% for placebo (P < 0.05). Similar changes were observed for symptom scores, with a successive decrease of 39.7% (SLIT) and fluctuations between +13.6% and -1.51% for placebo (P < 0.05). Combined score (P = 0.0508) and symptom score improvements (P = 0.0144) with SLIT continued during follow up. Increases in specific IgG(4) observed in the first season were sustained for SLIT vs placebo throughout treatment (P = 0.0001). Titration and daily SLIT were well tolerated. No serious systemic or anaphylactic reactions were reported.
Seasonal SLIT with ultra-rush titration is well tolerated and effective from the first treatment season onwards. These data indicate a carry-over effect of seasonal SLIT.
支持舌下免疫疗法（SLIT）存在延续效应的数据很少。这项随机、双盲、安慰剂对照研究评估了使用同期治疗的草花粉SLIT的疗效、延续效应和安全性。
草花粉过敏患者（7.9 - 64.7岁）在花粉季节开始时，每20分钟接受一次递增剂量（30、90、150和300 IR）的5种草花粉混合物的超快速滴定，随后每天300 IR直至花粉季节结束。一个基线季节（无SLIT）之后是连续三个治疗季节和一个随访季节。记录症状、用药情况和不良事件，并测量特异性免疫球蛋白（Ig）E和IgG(4)。
对213例随机分组患者中的183例进行了数据分析。各季节的平均治疗持续时间有所不同（81.8 - 92.7天）。综合评分（症状和用药情况）在各治疗季节逐渐改善（SLIT与基线相比改善高达44.7%），而安慰剂组在 - 11.3%至 - 14.8%之间波动（P < 0.05）。症状评分也观察到类似变化，SLIT组连续下降39.7%，安慰剂组在 + 13.6%至 - 1.51%之间波动（P < 0.05）。随访期间，SLIT组的综合评分改善（P = 0.0508）和症状评分改善（P = 0.0144）仍持续。与安慰剂相比，SLIT组在整个治疗过程中，第一季观察到的特异性IgG(4)增加得以持续（P = 0.0001）。滴定和每日SLIT耐受性良好。未报告严重的全身性或过敏反应。
超快速滴定的季节性SLIT耐受性良好，从第一个治疗季节起就有效。这些数据表明季节性SLIT存在延续效应。
