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在 COVID-19 大流行期间,现实生活中皮下免疫治疗变应原的依从性。

Adherence to subcutaneous immunotherapy with aeroallergens in real-life practice during the COVID-19 pandemic.

机构信息

Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Adult Immunology and Allergy Clinic, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey.

出版信息

Allergy. 2022 Jan;77(1):197-206. doi: 10.1111/all.14876. Epub 2021 May 10.

Abstract

BACKGROUND

The success of subcutaneous immunotherapy (SCIT) mostly depends on regular injections. Our aim was to investigate adherence to SCIT with aeroallergens during the COVID-19 pandemic and demonstrate clinical consequences of treatment disruptions in real life.

METHODS

Visual analogue scale for quality of life (VAS-QoL), VAS for symptom scores (VAS-symptom), medication scores (MSs), and total symptom scores (TSS-6) were recorded during the pandemic in 327 adult allergic rhinitis and/or asthmatic patients receiving maintenance SCIT, and these scores were compared with the pre-pandemic data. Patients were grouped according to SCIT administration intervals; no delay (Group 1), <2 months (Group 2), and ≥2-month intervals (Group 3).

RESULTS

A total of 104 (31.8%) patients (Group 3) were considered as nonadherent which was mostly related to receiving SCIT with HDMs and using public transportation for reaching the hospital. Median MS, VAS-symptom, and TSS-6 scores of Group 3 patients during the pandemic were higher than the pre-pandemic scores (p = 0.005, p < 0.001, p < 0.001, respectively), whereas median VAS-QoL scores of Group 3 during the pandemic were lower than the pre-pandemic scores (p < 0.001). Median TSS-6 and VAS-symptom scores were the highest in Group 3 compared with other groups (p < 0.001 for each comparison). Median VAS-QoL scores were the lowest in Group 3 compared with Group 1 and Group 2 (p < 0.001, p = 0.043, respectively).

CONCLUSION

When precautions in allergy clinics are carefully applied, adherence to SCIT can be high during a pandemic. Patients must be encouraged to regularly adhere to SCIT injections since delays in SCIT administration can deteriorate clinical symptoms.

摘要

背景

皮下免疫疗法 (SCIT) 的成功在很大程度上取决于定期注射。我们的目的是研究在 COVID-19 大流行期间接受变应原皮下免疫治疗的患者的治疗依从性,并在真实生活中展示治疗中断的临床后果。

方法

在大流行期间,327 名接受维持性 SCIT 的成人过敏性鼻炎和/或哮喘患者记录了生活质量视觉模拟量表 (VAS-QoL)、症状评分视觉模拟量表 (VAS-symptom)、药物评分 (MSs) 和总症状评分 (TSS-6),并将这些评分与大流行前的数据进行比较。患者根据 SCIT 给药间隔分组;无延迟 (第 1 组)、<2 个月 (第 2 组) 和≥2 个月间隔 (第 3 组)。

结果

共有 104 名 (31.8%) 患者 (第 3 组) 被认为是不依从的,这主要与接受 HDM 的 SCIT 和使用公共交通工具前往医院有关。第 3 组患者在大流行期间的 MS 中位数、VAS-symptom 和 TSS-6 评分均高于大流行前的评分 (p=0.005、p<0.001、p<0.001,分别),而第 3 组患者在大流行期间的 VAS-QoL 评分中位数则低于大流行前的评分 (p<0.001)。与其他组相比,第 3 组的 TSS-6 和 VAS-symptom 评分中位数最高 (p<0.001 每项比较)。与第 1 组和第 2 组相比,第 3 组的 VAS-QoL 评分中位数最低 (p<0.001、p=0.043)。

结论

当在过敏诊所仔细应用预防措施时,大流行期间对 SCIT 的依从性可以很高。必须鼓励患者定期坚持 SCIT 注射,因为 SCIT 给药的延迟会使临床症状恶化。

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