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超短疗程的加强针在复发性草花粉引起的过敏性鼻结膜炎中有效。

Ultra-short-course booster is effective in recurrent grass pollen-induced allergic rhinoconjunctivitis.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Center for Rhinology and Allergology, Wiesbaden, Germany.

出版信息

Allergy. 2018 Jan;73(1):187-195. doi: 10.1111/all.13240. Epub 2017 Sep 5.

Abstract

BACKGROUND

A relevant proportion of allergic rhinoconjunctivitis (ARC) patients experience recurrent symptoms after successfully completing allergen immunotherapy (AIT). This prospective, controlled, noninterventional study used internationally standardized instruments to determine the clinical effects of a preseasonal, ultra-short-course booster AIT on clinical outcome parameters.

METHODS

This two-arm study included patients aged ≥12 years with recurrent grass pollen-induced seasonal AR who had completed a successful course of any grass pollen AIT at least 5 years before enrolment. Overall, 56 patients received one preseasonal short-course booster AIT using tyrosine-absorbed grass pollen allergoids containing the adjuvant monophosphoryl lipid A (MPL ); 51 control patients received symptomatic medication. The combined symptom and medication score (CSMS) was recorded in the (peak) grass pollen season. Furthermore, concomitant (antiallergic) medication use, the patients' state of health, Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) results and safety/tolerability of the treatment were assessed.

RESULTS

The CSMS in the peak grass pollen season was significantly lower in the booster AIT group (Δ=38.4%, P<.01). Moreover, significantly more patients in this group used no concomitant antiallergic medication throughout the peak grass pollen season. Twice as many patients in the booster AIT group as in the control group reported having a better state of health than in the preceding season. MiniRQLQ results showed significant differences favouring the booster AIT. The booster AIT was generally well tolerated, with only two patients reporting mild, grade 1 systemic adverse events.

CONCLUSION

Booster AIT using tyrosine-absorbed allergoids containing the adjuvant MPL effectively prevents re-occurrence of symptoms in patients with grass pollen-induced ARC.

摘要

背景

相当比例的过敏性鼻结膜炎(ARC)患者在成功完成过敏原免疫治疗(AIT)后会出现反复症状。这项前瞻性、对照、非干预性研究使用国际标准化工具来确定 preseasonal、超短疗程 AIT 对临床结果参数的临床效果。

方法

这项双臂研究纳入了年龄≥12 岁、有反复发作的草花粉诱导季节性 AR 病史的患者,这些患者在入组前至少 5 年已完成任何草花粉 AIT 的成功疗程。共有 56 例患者接受了含有佐剂单磷酰脂质 A(MPL)的酪氨酸吸收草花粉变应原的 preseasonal 短疗程 AIT 强化治疗;51 例对照患者接受对症药物治疗。在(高峰期)草花粉季节记录综合症状和药物评分(CSMS)。此外,还评估了伴随(抗过敏)药物的使用、患者的健康状况、迷你鼻结膜炎生活质量问卷(MiniRQLQ)结果以及治疗的安全性/耐受性。

结果

在高峰期草花粉季节,强化 AIT 组的 CSMS 显著降低(Δ=38.4%,P<.01)。此外,该组中更多的患者在整个高峰期草花粉季节均未使用伴随的抗过敏药物。与对照组相比,强化 AIT 组有两倍多的患者报告说健康状况较前一季有所改善。MiniRQLQ 结果显示,强化 AIT 组具有显著优势。强化 AIT 总体耐受性良好,仅有两名患者报告有轻度、1 级全身性不良反应。

结论

使用含有佐剂 MPL 的酪氨酸吸收变应原的 AIT 强化治疗可有效预防草花粉诱导的 ARC 患者症状的再次发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0e3/5763416/2da297a222d5/ALL-73-187-g001.jpg

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