Yu-E Qin1, Jing-Ran Mao, Yue-chan Sang, Wen-Xiu Li. 1. International Health Care Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hang Zhou, China.
Abstract
BACKGROUND: The oral route for administration of allergen immunotherapy has been explored since the 1900s. We attempted to evaluate the efficacy and safety of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in patients with atopic dermatitis (AD) and investigate related factors influencing the patients' compliance. METHODS: A total of 107 patients with AD were randomized to receive either D. farinae drops plus pharmacotherapy (treatment group, n = 58) or only pharmacotherapy (control group, n = 49). Patients' compliance, the total effective rate, daily drug scores, visual analogue scale (VAS) scores, and IgG4 level were compared respectively between two groups at different time points. RESULTS: Twenty-three cases have withdrawn from the study. The total effective rate in the treatment group (77.78%) was significantly higher than the control group (53.85%) (P < 0.05). The treatment group was significantly reduced in daily drug scores and VAS scores compared with the control group at 12 months follow-up. Meanwhile, at the end of therapy, a significant difference was found in the change in average daily drug scores (difference from 1 month) between two groups (P < 0.01); The treatment group evidently had a higher level of serum-specific IgG4 than the control group at 6 and 12 month of treatment (P < 0.05). CONCLUSION:Dermatophagoides farinae drops are a safe and effective SLIT for patients with AD, which was proven to reduce the need for medicine. In addition, SLIT could induce a tolerogenic IgG4 response to mite allergen correlated with favorable clinical efficacy. Standardization of specific immunotherapy is essential to ensure therapeutic efficacy and compliance.
RCT Entities:
BACKGROUND: The oral route for administration of allergen immunotherapy has been explored since the 1900s. We attempted to evaluate the efficacy and safety of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in patients with atopic dermatitis (AD) and investigate related factors influencing the patients' compliance. METHODS: A total of 107 patients with AD were randomized to receive either D. farinae drops plus pharmacotherapy (treatment group, n = 58) or only pharmacotherapy (control group, n = 49). Patients' compliance, the total effective rate, daily drug scores, visual analogue scale (VAS) scores, and IgG4 level were compared respectively between two groups at different time points. RESULTS: Twenty-three cases have withdrawn from the study. The total effective rate in the treatment group (77.78%) was significantly higher than the control group (53.85%) (P < 0.05). The treatment group was significantly reduced in daily drug scores and VAS scores compared with the control group at 12 months follow-up. Meanwhile, at the end of therapy, a significant difference was found in the change in average daily drug scores (difference from 1 month) between two groups (P < 0.01); The treatment group evidently had a higher level of serum-specific IgG4 than the control group at 6 and 12 month of treatment (P < 0.05). CONCLUSION:Dermatophagoides farinae drops are a safe and effective SLIT for patients with AD, which was proven to reduce the need for medicine. In addition, SLIT could induce a tolerogenic IgG4 response to mite allergen correlated with favorable clinical efficacy. Standardization of specific immunotherapy is essential to ensure therapeutic efficacy and compliance.
Authors: Oliver Pfaar; Tobias Ankermann; Matthias Augustin; Petra Bubel; Sebastian Böing; Randolf Brehler; Peter A Eng; Peter J Fischer; Michael Gerstlauer; Eckard Hamelmann; Thilo Jakob; Jörg Kleine-Tebbe; Matthias Volkmar Kopp; Susanne Lau; Norbert Mülleneisen; Christoph Müller; Katja Nemat; Wolfgang Pfützner; Joachim Saloga; Klaus Strömer; Peter Schmid-Grendelmeier; Antje Schuster; Gunter Johannes Sturm; Christian Taube; Zsolt Szépfalusi; Christian Vogelberg; Martin Wagenmann; Wolfgang Wehrmann; Thomas Werfel; Stefan Wöhrl; Margitta Worm; Bettina Wedi; Susanne Kaul; Vera Mahler; Anja Schwalfenberg Journal: Allergol Select Date: 2022-09-06
Authors: Ji Hyun Lee; Jung Eun Kim; Gyeong-Hun Park; Jung Min Bae; Ji Yeon Byun; Min Kyung Shin; Tae Young Han; Seung Phil Hong; Yong Hyun Jang; Hye One Kim; Chan Ho Na; Bark-Lynn Lew; JiYoung Ahn; Chang Ook Park; Young-Joon Seo; Yang Won Lee; Sang Wook Son; Eung Ho Choi; Young Lip Park; Joo Young Roh Journal: Ann Dermatol Date: 2021-11-04 Impact factor: 1.444
Authors: Herman Tam; Moises A Calderon; Logan Manikam; Helen Nankervis; Ignacio García Núñez; Hywel C Williams; Stephen Durham; Robert J Boyle Journal: Cochrane Database Syst Rev Date: 2016-02-12