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从患者和医生角度看变应原特异性免疫疗法的临床疗效

Clinical Efficacy of Allergen-Specific Immunotherapy from Patient and Physician Perspectives.

作者信息

Shin Yoo Seob, Jung Jae Woo, Park Jung Won, Choi Jeong Hee, Kwon Jae Woo, Lee Sooyoung, Kim Ji Hye, Lee Sang Min, Ahn Young Min, Han Man Yong

机构信息

Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2019 May;60(5):446-453. doi: 10.3349/ymj.2019.60.5.446.

Abstract

PURPOSE

Allergen-specific immunotherapy (AIT) is the only curative treatment for allergic diseases, but a few allergic patients receive AIT. In this multicenter cross-sectional study, we aimed to explore patient and physician perspectives on AIT through a questionnaire survey.

MATERIALS AND METHODS

Allergic patients who received subcutaneous immunotherapy for at least 1 year were asked to answer a questionnaire developed by an expert panel of allergen and immunotherapy workgroup in Korea.

RESULTS

A total of 267 patients (adults, 60.3%) with allergic rhinitis (91.4%), asthma (42.7%), or atopic dermatitis (20.2%) from referred hospitals completed the survey. Among patients and physicians, respectively, the overall rates of satisfaction with AIT for allergic rhinitis were 86.4% and 83.3% (kappa agreement=0.234, <0.001), and those for asthma were 85.3% and 72.9% (kappa agreement=0.373, <0.001). Moreover, pediatric asthmatic patients reported a significantly higher satisfaction rate than adult asthmatic patients after AIT (=0.040). Symptom severity (<0.001, respectively) and drug use for allergic rhinitis and asthma decreased after AIT. However, there was no significant difference in satisfaction rates between children and adults in allergic rhinitis (=0.736). Interestingly, 35.7% and 35% of allergic rhinitis and asthma patients, respectively, reported experiencing improvement in their symptoms within 6 months of starting AIT.

CONCLUSION

In this study evaluating the perspectives of patients and physicians on AIT, the majority of patients were satisfied with the efficacy and safety of AIT, but not its cost. AIT should be recommended for AR and allergic patients.

摘要

目的

变应原特异性免疫疗法(AIT)是过敏性疾病的唯一治愈性治疗方法,但接受AIT的过敏患者较少。在这项多中心横断面研究中,我们旨在通过问卷调查探索患者和医生对AIT的看法。

材料与方法

要求接受皮下免疫疗法至少1年的过敏患者回答由韩国变应原和免疫疗法工作组专家小组制定的问卷。

结果

来自转诊医院的267例患者(成人占60.3%)完成了调查,这些患者患有过敏性鼻炎(91.4%)、哮喘(42.7%)或特应性皮炎(20.2%)。在患者和医生中,对过敏性鼻炎AIT的总体满意度分别为86.4%和83.3%(kappa一致性=0.234,P<0.001),对哮喘AIT的总体满意度分别为85.3%和72.9%(kappa一致性=0.373,P<0.001)。此外,小儿哮喘患者在AIT后报告的满意度显著高于成人哮喘患者(P=0.040)。AIT后过敏性鼻炎和哮喘的症状严重程度(均P<0.001)及药物使用减少。然而,过敏性鼻炎患者中儿童和成人的满意度之间无显著差异(P=0.736)。有趣的是,分别有35.7%和35%的过敏性鼻炎和哮喘患者报告在开始AIT的6个月内症状有所改善。

结论

在这项评估患者和医生对AIT看法的研究中,大多数患者对AIT的疗效和安全性满意,但对其费用不满意。对于过敏性鼻炎和过敏患者应推荐AIT。

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