Department of Otolaryngology Head and Neck Surgery, The First Hospital, Shanxi Medical University, Taiyuan, China; Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Shanxi Medical University, Taiyuan, China.
Nursing College of Shanxi Medical University, Taiyuan, China.
Am J Otolaryngol. 2023 Sep-Oct;44(5):103942. doi: 10.1016/j.amjoto.2023.103942. Epub 2023 Jun 7.
Patients with seasonal allergic rhinoconjunctivitis (SARC) might seek evaluation and treatment when symptoms appear during the pollen season. It is unclear whether coseasonal-initiated sublingual immunotherapy (SLIT) would be effective and safe for SARC. This study aims to identify the feasibility of initiating Artemisia annua SLIT during the pollen season.
Sixty patients with Artemisia-induced SARC were equally recruited into the SLIT and control groups during the pollen season in 2021. The SLIT group was treated with standardized Artemisia annua SLIT drops using a modified dosing schedule combined with pharmacotherapy, while the control group only received pharmacotherapy. Diary cards for clinical symptoms, rescue medication use, and adverse events (AEs) were recorded during the pollen seasons. Objective measures, including average daily combined scores of medication and rhinoconjunctivitis symptoms (CSMRS), total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), and the score of visual analog scale (VAS) were calculated to evaluate the efficacy of SLIT. Safety was assessed through the occurrence and severity of AEs.
In total, 80.0 % (24/30) patients in the SLIT group and 86.67 % (26/30) patients in the control group completed the study. The severity of SARC, which was assessed by objective measures including CSMRS, TRSS, TMS, and VAS of the SLIT group and the control group, was generally at the same level during the 2021 pollen season, except for the medical consumption, which the score of TMS was slightly higher in the SLIT group. After one year of treatment, the scores of CSMRS, TRSS, and VAS in the SLIT group were significantly improved compared with the control group (all P < 0.001), and the difference in the TMS between the two groups disappeared (P > 0.05). Moreover, clinical improvement of the four objective measures was also observed in the SLIT group compared with the baseline value (P < 0.001). Overall, 9/24 patients in the SLIT group experienced mild local AEs, and two patients experienced mild systemic AEs during the SLIT period.
This controlled preliminary study identified that coseasonal-initiated Artemisia annua SLIT treatment for one year was generally safe and effective in improving the symptoms of SARC patients induced by Artemisia annua pollen.
季节性过敏性鼻结膜炎（SAR C）患者的症状可能会在花粉季节出现时寻求评估和治疗。目前尚不清楚季节性开始的舌下免疫疗法（SLIT）对 SAR C 是否有效和安全。本研究旨在确定在花粉季节开始青蒿 SLIT 的可行性。
2021 年花粉季节，60 名青蒿诱导的 SAR C 患者被平均招募到 SLIT 组和对照组。SLIT 组采用改良剂量方案联合药物治疗，使用标准化青蒿 SLIT 滴剂进行治疗，对照组仅接受药物治疗。在花粉季节期间，记录临床症状、急救药物使用和不良事件（AE）的日记卡。计算平均每日药物和鼻结膜炎症状综合评分（CSMRS）、总鼻结膜炎症状评分（TRSS）、总药物评分（TMS）和视觉模拟评分（VAS）的平均值，以评估 SLIT 的疗效。通过 AE 的发生和严重程度评估安全性。
共有 80.0%（24/30）的 SLIT 组患者和 86.67%（26/30）的对照组患者完成了研究。SLIT 组和对照组患者的 SAR C 严重程度通过客观措施评估，包括 CSMRS、TRSS、TMS 和 VAS，除了 SLIT 组的 TMS 评分略高外，在 2021 年花粉季节总体处于同一水平。治疗一年后，SLIT 组的 CSMRS、TRSS 和 VAS 评分明显优于对照组（均 P<0.001），两组之间 TMS 评分的差异消失（P>0.05）。此外，与基线值相比，SLIT 组的四个客观措施的临床改善也得到了观察（P<0.001）。总的来说，SLIT 组有 9/24 名患者出现轻度局部 AE，2 名患者在 SLIT 期间出现轻度全身 AE。
这项对照初步研究确定，在花粉季节开始一年的季节性青蒿 SLIT 治疗通常是安全有效的，可以改善青蒿花粉诱导的 SAR C 患者的症状。
