Allergy and Immunology Department, Niguarda Hospital, Milan, Italy.
Allergy Department, San Marco General Hospital, Bergamo, Italy.
J Asthma Allergy. 2013 Dec 4;6:127-33. doi: 10.2147/JAA.S53801. eCollection 2013.
An important subpopulation in allergic rhinitis is represented by patients with severe form of disease that is not responsive to drug treatment. It has been reported that grass pollen subcutaneous immunotherapy is effective in drug-resistant patients. In a real-life study, we evaluated the efficacy of 5-grass pollen tablets in patients with grass pollen-induced allergic rhinitis not responsive to drug therapy.
We carried out this multicenter observational study in adults and adolescents with grass-induced allergic rhinitis not responsive to drug therapy who were treated for a year with 5-grass pollen tablets. Clinical data collected before and after sublingual immunotherapy (SLIT) included Allergic Rhinitis and its Impact on Asthma (ARIA) classification of allergic rhinitis, response to therapy, and patient satisfaction.
Forty-seven patients entered the study. By ARIA classification, three patients had moderate to severe intermittent allergic rhinitis, ten had mild persistent allergic rhinitis, and 34 had moderate to severe persistent allergic rhinitis. There were no cases of mild intermittent allergic rhinitis before SLIT. After SLIT, 33 patients had mild intermittent allergic rhinitis, none had moderate to severe intermittent allergic rhinitis, seven had mild persistent allergic rhinitis, and seven had moderate to severe persistent allergic rhinitis. The mean medication score decreased from 4.2±1.3 before to 2.4±2.0 after SLIT (P<0.01), representing a reduction of 42%. The response to treatment before SLIT was judged as poor by 70% of patients and very poor by 30%. Patient satisfaction was significantly increased after SLIT (P<0.01).
In real life, most patients with grass pollen-induced allergic rhinitis not responsive to drug treatment can achieve control of the condition with one season of treatment using 5-grass pollen tablets.
变应性鼻炎的一个重要亚群是疾病严重且对药物治疗无反应的患者。据报道,草花粉皮下免疫疗法对耐药患者有效。在一项真实研究中,我们评估了 5 种草花粉片在对药物治疗无反应的草花粉诱发变应性鼻炎患者中的疗效。
我们对 47 例对药物治疗无反应的草花粉诱发变应性鼻炎的成年和青少年患者进行了这项多中心观察性研究,他们接受了一年的 5 种草花粉片舌下免疫治疗。在舌下免疫治疗前后收集的临床数据包括变应性鼻炎及其对哮喘的影响(ARIA)分类的变应性鼻炎、对治疗的反应和患者满意度。
按 ARIA 分类,3 例患者为中重度间歇性变应性鼻炎,10 例为轻度持续性变应性鼻炎,34 例为中重度持续性变应性鼻炎。在 SLIT 前无轻度间歇性变应性鼻炎病例。SLIT 后,33 例患者为轻度间歇性变应性鼻炎,无一例为中重度间歇性变应性鼻炎,7 例为轻度持续性变应性鼻炎,7 例为中重度持续性变应性鼻炎。用药评分从 SLIT 前的 4.2±1.3 均值降至 SLIT 后的 2.4±2.0(P<0.01),降幅为 42%。SLIT 前,70%的患者治疗反应评定为差,30%的患者为极差。SLIT 后患者满意度显著提高(P<0.01)。
在真实生活中,大多数对药物治疗无反应的草花粉诱发变应性鼻炎患者在接受一个季节的 5 种草花粉片治疗后可以控制病情。