Effects of immunotherapy on symptoms, PEFR, spirometry, and airway responsiveness in patients with allergic asthma to house‐dust mites (D. pteronyssinus) on inhaled steroid therapy

Abstract

The present study was designed to investigate the effects of immunotherapy (IT) with an extract of Dermatophagoides pteronyssinus (Alergo-Merck Depot) during a 27-month period in patients with allergic asthma to house-dust mites. We included 11 patients (mean age 18 years) treated with a combination of IT and inhaled beclomethasone dipropionate (BDP) in comparison to another 11 (mean age 22 years) treated with BDP alone. We evaluated symptom scores, salbutamol use, peak expiratory flow rates (PEFR), spirometry, and bronchial hyperresponsiveness (BHR) during 18 months of therapy with BDP and in the 9 months after BDP interruption. The two kinds of treatment were efficient and comparable in relation to symptom score, salbutamol use, morning PEFR, FVC, and FEV1, but patients treated with IT and BDP had a faster improvement of BHR and PEFR variability. The interruption of BDP after 18 months of therapy was linked to an impairment of all end points, which were more pronounced in patients previously treated only with BDP. These findings suggest that in selected asthmatic patients allergic to house-dust mites, the association of IT and BDP is more effective than therapy with this inhaled steroid alone due to a faster and more striking improvement during the first months of treatment and to a lower rate of relapse after the interruption of therapy with BDP.

Efficacy and Safety of Sublingual Immunotherapy in Children Aged 3–13 Years with Allergic Rhinitis

“…There are few studies focused on this aspect that reported similar results in the literature. Costa et al , 25 found that immunotherapy shows faster and more striking improvements during the 1st months and a lower rate of relapse after disruption of drug therapy when compared with drugs alone. Similar results were also reported by Shaikh.…”

“…The subsequent improvements in this study, especially those after the 7th month, may also not be simply attributed to psychological effects, because they are only continued and maintained in the SLIT group as reported by other studies. 25,26 In other words, these results may also imply that the benefits from SLIT treatment may become increasingly apparent as the treatment is performed. The other limitation is the short time of study.…”

Immunotherapy vs inhaled budesonide in bronchial asthma: an open, parallel, comparative trial

“…wbere the benefits seem to last for a longer period of time. As bas been concluded in tbe Torres Costa et al study [36]. it seems logical that a combination of inhaled CS and SIT would be more effective than either of the two alone due to a faster and more striking improvement during the first months of treatment and to a lower rate of relapse after the interruption of inhaled CS.…”

“…This is the first randomized study comparing the effects of BUD vs SIT, although there has been a recent study by Torres Costa et al [36] comparing SIT plus beclomethasone dipropionate (BDP) again.st BDP alone. Torres Costa e!…”

Allergen immunotherapy in asthma; what is new?

“…With the highest dose, a significant reduction in mcg of corticosteroids was seen (p = 0.004) and the relative mean reduction was 42 %. The less recent studies involved smallest samples [ 21 , 29 , 39 , 40 ]: overall demonstrated a steroid-sparing effect of AIT in asthma, but the extent of this effect was largely variable, and sometimes of uncertain clinical relevance. Finally, Marogna et al [ 41 ] compared the effect, as add-on treatment, of inhaled budesonide and SLIT, and found that over a 3-year period, SLIT was overall more effective than budesonide in reducing symptoms and bronchial hyperreativity.…”