The changes in different symptom scores during subcutaneous immunotherapy in Chinese house dust mite allergic patients: a two-year, observational study

Abstract

BackgroundSubcutaneous immunotherapy is an effective and safe treatment for allergic rhinitis and allergic asthma. Different symptom scores are used to evaluate the efficacy of subcutaneous immunotherapy in clinical trials.MethodA total of 58 allergic rhinitis patients sensitised to house dust mites, with or without mild asthma, were included. Symptom score, medication score, visual analogue scale score and quality of life were assessed before and after 6, 12 and 24 months of subcutaneous immunotherapy.ResultsAfter two years of subcutaneous immunotherapy, asthma symptom scores nearly reached zero, whereas the scores remained higher for nasal symptoms. The changes in asthma symptom scores were markedly different (p < 0.05) and occurred faster than the changes in nasal symptom scores when compared between monosensitised and polysensitised groups. Significant reductions in visual analogue scale score and medication score were demonstrated after subcutaneous immunotherapy.ConclusionTwo-year subcutaneous immunotherapy with house dust mite vaccine is an effective treatment for both monosensitised and polysensitised allergic patients. The changes in asthma symptom scores were markedly different and occurred quicker than the changes in nasal symptom scores in Chinese house dust mite allergic patients.

Clinical effectiveness of house dust mite immunotherapy in mono- versus poly-sensitised patients with allergic rhinitis: a systematic review and meta-analysis

“…In three (24,25,28) out of nine studies, the baseline nasal symptom score in polysensitised patients was significantly higher than that in monosensitised patients. Therefore, we performed a sensitivity analysis omitting these three studies (24,25,28) .…”

“…In three (24,25,28) out of nine studies, the baseline nasal symptom score in polysensitised patients was significantly higher than that in monosensitised patients. Therefore, we performed a sensitivity analysis omitting these three studies (24,25,28) . In the sensitivity analysis with six studies (21)(22)(23)26,27,29) , the clinical effectiveness of HDM AIT regarding nasal symptom score did not significantly differ between monosensitised and polysensitised patients (SMD: -3.68 versus -3.53, respectively, p = 0.876; Figure 3), which is consistent with the result of the pooled analysis including all nine studies.…”

“…Nasal symptom score was assessed by total nasal symptom score (TNSS) in seven studies (21)(22)(23)(24)26,28,29) , combined symptom medication score (CSMS) in one study (27) , and visual analogue scale (VAS) in one study (25) , respectively. There was a significant decrease in the nasal symptom score from pre-treatment to post-treatment in both monosensitised and polysensitised patients (SMD: -3.06, 95% CI, -4.14 to -1.99 and SMD: -3.12, 95% CI, -4.20 to -2.03 in monosensitised and polysensitised patients, respectively; Figure 2) with a significant heterogeneity among the studies (I 2 = 96%; p < 0.01 in both monosensitised and polysensitised patients).…”

“…All studies investigated nasal symptom or/and use of rescue medication and quality of life. Among the nine studies, seven (21,22,(24)(25)(26)(27)(28) were conducted on AR patients with or without asthma, the study of Li (23) was conducted on AR patients with asthma, while the study of Zhang (29) was conducted on AR patients without asthma. AR was diagnosed according to guidelines, such as the Allergic Rhinitis and Its Impact on Asthma (ARIA) guideline (41) in all individual studies except the study of Kim (26) that did not report on the diagnosis of AR.…”

“…For grass pollen allergen, large double-blind placebo-controlled clinical trials show that the benefits of SLIT with single-allergen grass pollen in polysensitised patients are comparable to those in monosensitised patients (3,20) . However, most lines of supporting evidence on a comparison of the clinical effectiveness of single-allergen AIT with house dust mite (HDM) extracts in AR patients polysensitised or monosensitised to HDM, are reported in observational studies (21)(22)(23)(24)(25)(26)(27)(28)(29) , and there is a lack of systematic reviews and meta-analyses to demonstrate the clinical effectiveness of HDM AIT in polysensitised patients compared to monosensitised patients. This systematic review and meta-analysis aimed to compare the clinical effectiveness of single-allergen HDM AIT in AR patients polysensitised or monosensitised to HDM.…”