Harintajinda Supamas, Klangkalya Natchanun, Kanchongkittiphon Watcharoot, Rerkpattanapipat Ticha, Kerddonfak Saowanee, Manuyakorn Wiparat
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Allergy, Immunology and Rheumatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Asian Pac J Allergy Immunol. 2024 Sep 22. doi: 10.12932/AP-140224-1785.
House dust mite subcutaneous immunotherapy (HDM SCIT) is a therapeutic option for allergic rhinitis (AR) patients who are unable to properly manage symptoms with standard medications.
This study aimed to determine long-term efficacy and identify predictive factors in the clinical remission of AR patients who completed and discontinued HDM SCIT.
This study included 240 AR patients, who completed a three-year course of HDM SCIT at two tertiary hospitals and were currently being discontinued. We followed-up the patients to ask about their current symptoms and allergy medication. Clinical remission was defined by patients who no longer required daily intranasal steroid or oral antihistamine. We compared patients in clinical remission to those still taking medication.
The enrolled patients had a median age of 21.0 (11.0-36.0) years at the time they began HDM SCIT. The clinical remission of AR was achieved in 174 (72.5%) patients. Starting HDM SCIT before the age of 15 and not having asthma were identified as significant and independent predictors of remission (aOR 4.44; 95%CI, 1.72-11.50; p-value 0.002, and 2.67, 95%CI 1.00-7.12; p-value 0.049), respectively, as determined by multivariate logistic regression analysis. There were no significant differences in HDM SCIT duration or sensitization patterns between patients in remission and those on medication after discontinuing HDM SCIT for at least one year.
HDM SCIT exhibited persistent long-term efficacy after treatment discontinuation. Starting HDM SCIT before the age of 15 and without asthma comorbidity might be predictors of AR remission with HDM SCIT.
屋尘螨皮下免疫疗法（HDM SCIT）是一种针对无法通过标准药物有效控制症状的过敏性鼻炎（AR）患者的治疗选择。
本研究旨在确定完成并停用HDM SCIT的AR患者临床缓解的长期疗效并识别预测因素。
本研究纳入了240例AR患者，这些患者在两家三级医院完成了为期三年的HDM SCIT疗程且目前正在停药。我们对患者进行随访，询问他们当前的症状和过敏药物使用情况。临床缓解定义为不再需要每日使用鼻内类固醇或口服抗组胺药的患者。我们将临床缓解的患者与仍在服药的患者进行比较。
入组患者开始HDM SCIT时的中位年龄为21.0（11.0 - 36.0）岁。174例（72.5%）患者实现了AR的临床缓解。多因素逻辑回归分析确定，15岁之前开始HDM SCIT以及没有哮喘是缓解的显著且独立的预测因素（调整后比值比分别为4.44；95%置信区间，1.72 - 11.50；p值0.002，以及2.67，95%置信区间1.00 - 7.12；p值0.049）。在至少停药一年后，缓解患者与仍在服药患者之间的HDM SCIT疗程时长或致敏模式没有显著差异。
HDM SCIT在停药后显示出持续的长期疗效。15岁之前开始HDM SCIT且无哮喘合并症可能是HDM SCIT治疗AR缓解的预测因素。
