Allergy Unit, Verona General Hospital, Verona, Italy.
Curr Opin Allergy Clin Immunol. 2009 Dec;9(6):544-8. doi: 10.1097/ACI.0b013e328332b8df.
The main feature of allergen-specific immunotherapy is its capacity to modify the natural history of the disease, reducing the development of asthma and new sensitizations after 3-4 years of treatment. For this reason, adherence to the therapy is mandatory, as happens for all chronic medical treatment.
Though subcutaneous immunotherapy is administered directly by physicians, the rate of adherence is surprisingly low, at less than 70%. The explanations for a poor subcutaneous immunotherapy adherence include inconvenience, lack of efficacy, costs and loss of working hours.Local nasal immunotherapy has a very low adherence rate (27%), due to the local nasal side effects.For sublingual immunotherapy, data are available from clinical trials and postmarketing surveys, which are favourable overall (rates of compliance >75%). Cost was the most common reason for discontinuation, followed by inconvenience, feeling of inefficacy and side effects.
Studies addressing the adherence to allergen-specific immunotherapy in literature are lacking. In real life, costs and patient education are crucial issues in conditioning adherence to this treatment. Reduction of costs and more efforts in education of patients and also specialists may improve the adherence to immunotherapy.
变应原特异性免疫疗法的主要特征是其改变疾病自然史的能力，在治疗 3-4 年后减少哮喘的发展和新的致敏。出于这个原因，必须坚持治疗，就像所有慢性药物治疗一样。
虽然皮下免疫疗法由医生直接给药，但令人惊讶的是，其依从率却很低，低于 70%。皮下免疫疗法依从性差的解释包括不便、疗效不佳、费用和工作时间损失。局部鼻内免疫疗法的依从率非常低（27%），这是由于局部鼻内副作用所致。对于舌下免疫疗法，临床试验和上市后调查的数据总体上是有利的（依从率>75%）。费用是停药最常见的原因，其次是不便、无效感和副作用。
文献中缺乏关于变应原特异性免疫疗法依从性的研究。在现实生活中，成本和患者教育是影响这种治疗依从性的关键问题。降低成本和更多地教育患者和专家可能会提高免疫疗法的依从性。
