Shen Y, Ke X, Yang Y C, Huang J J, Liu J, Zhang M, Chen Z Q, Hong S L
Department of Otorhinolaryngology Head and Neck Surgry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Dec 7;57(12):1491-1496. doi: 10.3760/cma.j.cn115330-20220104-00003.
To observe the clinical efficacy, safety, compliance, and cost-effectiveness of rush immunotherapy (RIT) and conventional immunotherapy (CIT) in patients with allergic rhinitis (AR), so as to evaluate the clinical significance of CIT and preliminarily explore its economic value. A study was conducted on 72 AR patients who had received specific immunotherapy from Oct 2019 to Jun 2020 in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, including 39 males and 33 females, aging 8 to 60 years. RIT or CIT was performed respectively according to the patients' wishes. There were 35 cases in the RIT group and 37 cases in the CIT group, all subjects were followed up for 1 year. Visual analysis scale (VAS) and effectiveness were used to evaluate the clinical efficacy. Systemic adverse reactions were used to assess safety. Failure rate was calculated to evaluate the compliance. The cost and cost-effectiveness ratio (CER) were conducted to evaluate the health economics preliminarily. After half a year and one year's treatment, both RIT and CIT groups had significant clinical efficacy and RIT group had more significant clinical efficacy than CIT group at half a year (76.67% 46.67%, χ=7.37, =0.007). During the dose accumulation phase, there was no significant difference in the incidence of systemic adverse reactions between the two groups (8.57% 8.10%, χ=0.05, =0.943), while the drop-out rate in the RIT group was significantly lower than that in the CIT group (0 13.51%, χ=5.08, =0.024). After one year, the costs in RIT group were significantly higher ((8 163.08±452.67) yuan (7 385.87±369.92) yuan, =-2.78, =0.009), while there was no statistical differences in CER between the two groups ((3 298.06±1 374.09) yuan/point (3 154.38±1 532.51) yuan/point, =-0.36, =0.418). Both RIT and CIT are beneficial for AR, and they have similar clinical efficacy, safety, and CER. RIT is more effective in the early stage, with higher patient compliance. Thus, RIT is worth promoting and exploring in clinic.
观察速发免疫疗法（RIT）和常规免疫疗法（CIT）治疗变应性鼻炎（AR）患者的临床疗效、安全性、依从性和成本效益，以评估CIT的临床意义并初步探讨其经济价值。对2019年10月至2020年6月在重庆医科大学附属第一医院耳鼻咽喉科接受特异性免疫治疗的72例AR患者进行研究，其中男性39例，女性33例，年龄8至60岁。根据患者意愿分别进行RIT或CIT治疗。RIT组35例，CIT组37例，所有受试者均随访1年。采用视觉分析量表（VAS）和疗效评估临床疗效，采用全身不良反应评估安全性，计算失败率评估依从性，进行成本及成本效益比（CER）分析初步评估卫生经济学。治疗半年和1年后，RIT组和CIT组临床疗效均显著，且RIT组在半年时临床疗效更显著（76.67%对46.67%，χ²=7.37，P=0.007）。在剂量累加阶段，两组全身不良反应发生率无显著差异（8.57%对8.10%，χ²=0.05，P=0.943），而RIT组脱落率显著低于CIT组（0对13.51%，χ²=5.08，P=0.024）。1年后，RIT组费用显著更高（（8163.08±452.67）元对（7385.87±369.92）元，t=-2.78，P=0.009），而两组CER无统计学差异（（3298.06±1374.09）元/分对（3154.38±1532.51）元/分，t=-0.36，P=0.418）。RIT和CIT对AR均有益，二者临床疗效、安全性及CER相似。RIT早期疗效更佳，患者依从性更高。因此，RIT在临床上值得推广和探索。
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