Lin Zhibin, Liu Qihong, Li Tianying, Chen Dong, Chen Dehua, Xu Rui
Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Int Forum Allergy Rhinol. 2016 Jan;6(1):82-7. doi: 10.1002/alr.21657. Epub 2015 Nov 17.
The safety and efficacy of sublingual immunotherapy (SLIT) have been demonstrated in the recent 2 decades. However, the data is still mixed regarding the efficacy of house dust mite (HDM) SLIT. The objective of this work was to evaluate the different clinical efficacy SLIT in patients with allergic rhinitis (AR) according to different durations of treatment.
A total of 500 subjects with HDM-induced AR were randomized to receive SLIT with Dermatophagoides farinae (Der.f) drops or pharmacotherapy with oral antihistamines. Patients in the SLIT group were further divided into SLIT1, SLIT2, and SLIT3 subgroups. After SLIT completion, a yearly follow-up visit was given to patients in the SLIT1 and SLIT2 subgroups. The total nasal symptom score (TNSS), the proportion of medication withdrawal, the visual analogue scale (VAS) score, and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores were assessed at each monthly visit.
Comparing with the baseline value, TNSS, VAS, and RQLQ were significantly improved in 3 SLIT subgroups after treatment (p < 0.05). In addition, patients in SLIT3 subgroup achieved the highest proportion of medication withdrawal compared to the SLIT1 and SLIT2 subgroups (p < 0.05). After 1-year follow-up, no significant differences were observed in TNSS, VAS scores, and the proportion of medication withdrawal of SLIT1 and SLIT2 subgroups (p > 0.05) with respect to the completion value. No severe systemic adverse events (AEs) were reported.
The randomized study suggested that 3-year courses of SLIT in patients with AR was more efficacious than 1-year or 2-year courses. Furthermore, patients achieved 1-year long-term clinical benefits from HDM SLIT.
舌下免疫疗法（SLIT）的安全性和有效性在最近20年已得到证实。然而，关于屋尘螨（HDM）舌下免疫疗法的疗效数据仍存在分歧。这项研究的目的是根据不同的治疗持续时间，评估舌下免疫疗法对过敏性鼻炎（AR）患者的不同临床疗效。
总共500名由HDM诱发的AR患者被随机分为两组，分别接受粉尘螨滴剂舌下免疫疗法或口服抗组胺药药物治疗。接受舌下免疫疗法的患者进一步分为SLIT1、SLIT2和SLIT3亚组。在完成舌下免疫疗法后，对SLIT1和SLIT2亚组的患者进行每年一次的随访。在每次每月随访时评估总鼻症状评分（TNSS）、停药比例、视觉模拟量表（VAS）评分和变应性鼻炎生活质量问卷（RQLQ）评分。
与基线值相比，治疗后3个舌下免疫疗法亚组的TNSS、VAS和RQLQ均有显著改善（p < 0.05）。此外，与SLIT1和SLIT2亚组相比，SLIT3亚组的患者停药比例最高（p < 0.05）。1年随访后，SLIT1和SLIT2亚组的TNSS、VAS评分及停药比例与完成治疗时的值相比，未观察到显著差异（p > 0.05）。未报告严重的全身性不良事件（AE）。
这项随机研究表明，AR患者接受3年疗程的舌下免疫疗法比1年或2年疗程更有效。此外，患者从HDM舌下免疫疗法中获得了1年的长期临床益处。
