Safety and efficacy of rush allergen-specific immunotherapy in Chinese allergic rhinitis patients

Abstract

The purpose of this prospective, open-IV clinical trial was to assess the safety and efficacy differences between Rush immunotherapy (RIT) and conventional immunotherapy in Chinese allergic rhinitis (AR) patients. The trial involved 174 patients with AR. They were divided into two groups according to their preference of therapy: RIT or conventional immunotherapy. A total of 162 patients completed a 1-year treatment course. For safety and effectiveness evaluation, the local and systemic adverse reactions were recorded throughout the initial phase of both groups. Weeks 0, 2, 5, and 17 were set as observation time points for immunoglobulin G (IgG) and IgG4. Besides that, another observation time point (Week 11) was added in for a visual analog scale (VAS) and a weekly drug dosage scale. In the RIT group, systemic adverse events of AR were similar to those of the conventional therapy group. LTB4 was descended. The VAS of the RIT group did not show a downward trend clearly, instead Week 5 was higher compared with Week 0. The weekly drug dosage scale did not indicate a significant decline, but there was a clear rise in IgG4 in the RIT group. The safety and efficacy of RIT for AR is positive, but further study is needed for improvement.

Metabolomics analysis of baicalin on ovalbumin-sensitized allergic rhinitis rats

“…In this study, we observed that LTA4 and LTB4 were increased, followed by arachidonic acid, which is in accordance with this theory [22]. LTB4, synthesized by LTA4 hydrolase from LTA4, is a leukotriene involved in inflammation that plays an important role in the development of AR [23]. These results indicated that arachidonic acid metabolism was also disordered in our study, and with high VIP, arachidonic acid might be used as a specific candidate biomarker for AR.…”

Principles of Allergen Immunotherapy and Its Clinical Application in China: Contrasts and Comparisons with the USA

“…RIT shows similar and even earlier onset of clinical efficacy compared to conventional AIT, and there is no evidence to support a difference in systemic adverse reactions [157]. Similarly, the cluster schedule reduced the time to reach maintenance dose and caused mild systemic adverse reactions with no differences compared to conventional schedules [158,159].…”

Chinese Guideline on allergen immunotherapy for allergic rhinitis

“…However, there is no standard RIT protocol around the world. Generally, 1 injection every 1-3 hours or even 1 injection every 15-60 minutes over a period of maintenance phase from about 4 hours to 7 days has been employed (29,(203)(204)(205). RIT is currently used mostly for bee venom and grass pollen immunotherapy.…”

“…RIT is currently used mostly for bee venom and grass pollen immunotherapy. Apart from SLIT, dust mites subcutaneous RIT has been reported less frequently (29,(206)(207)(208). Also, there is some evidence that the shortened treatment time of RIT, results in improved patient compliance to high allergen doses on resuming a conventional AIT schedule (209).…”

“…It is worth mentioning that the cluster schedule reported by Zhang and colleagues (26) in 2009 as a safe alternative to the conventional schedule with the advantage of achieving clinical effectiveness sooner has subsequently been referenced in several international guidelines of immunotherapy for allergy (27,28). More recently, a prospective, open-IV clinical trial by Qiu and colleagues (29) has confirmed the safety and efficacy of rush immunotherapy (RIT) and conventional immunotherapy in Chinese AR patients. Zhou and colleagues (30) investigated the current trends in the awareness and application status of AIT among Chinese ENT (ear, nose, and throat) specialists across China and concluded that whilst most of the specialists appeared to be in agreement with recent AIT progress and international guidelines, many areas still need to enhance the standardization and use of AIT in China.…”