"Sublingual Immunotherapy Effective in Treating Mite-Induced Allergic Rhinitis, Asthma: Presented at AAAAI"
By Paula Moyer
SAN ANTONIO, TX -- March 21, 2005 -- Patients with dust mite-induced allergic rhinitis and asthma have significantly fewer symptoms and require less medication after getting sublingual allergy immunotherapy, according to research presented here at the 61[st annual meeting of the American Academy of Allergy, Asthma, and Immunology.
The treatment, which is approved in Europe but not in the United States or Canada, is being developed as an alternative route of administration to the conventional immunotherapy injections. Although the sublingual formulation, typically given in drops or tablets, has been found effective in treating pollen-related allergies, there were few data regarding its efficacy against mite-induced allergy.
"Patients who received the sublingual treatment also reported less allergy-related work absenteeism than did those who received placebo," said principal investigator Carlo Lombardi, MD, professor of medicine at the University of Genoa in Genoa, Italy. "These findings indicate that the treatment's efficacy in mite-induced allergic symptoms is similar to that found with pollen-related allergies," he said during a presentation on March 20th.
In this randomised, double-blind, placebo-controlled study, Dr. Lombardi and colleagues recruited 68 patients who had been confirmed to have mite-induced rhinitis, asthma, or both. Patients, who were an average of 32 years old, underwent a baseline assessment for 1 year prior to enrolment in the study.
During the 2-year study period, patients received either standard antihistamine or prophylactic asthma treatment along with sublingual immunotherapy, which was given as soluble tablets of monomeric allergoid or placebo.
The investigators scored participants' rhinitis and asthma severity on a scale of 0 to 3. Participants recorded their drug consumption in a diary for the months of November through February for each year of the study period, and the investigators conducted an analysis of the pharmacoeconomics of both the drug consumption and the study treatment. In addition, patients filled out the Short Form-36 (SF-36) questionnaire at each observation period to determine patients' health-related quality of life.
Among the original cohort, 56 patients completed the study. The active and placebo groups had similar discontinuation rates. Dr. Lombardi said that there were no treatment-related adverse effects during the study period.
The investigators documented a significant reduction in the clinical scores for nasal obstruction, nasal itching and cough in the treatment group when compared to both the placebo group and baseline (P <.5 for both).
In the second year, the treatment group had a 25% reduction in drug consumption compared to baseline, while the placebo group had no change. Therefore, despite the cost of immunotherapy, the treatment group's care was less expensive than that of the placebo group, Dr. Lombardi said.
Analysis of unscheduled medical care showed that 25% of the treatment group required such visits, compared to 43% of the placebo group.
The investigators documented no change in the groups' SF-36 scores on most items compared to baseline. However, Dr. Lombardi stressed that all patients displayed a normal profile at baseline, and suggested that the patients' disease status was too mild to compromise health-related quality of life. However, the patients in the treatment group were more likely to report a "change in health status," Dr. Lombardi said.
[Presentation title: A 3-Year Randomized Controlled Study With Sublingual Immunotherapy in Mite-Induced Respiratory Allergy. Abstract 828]
|
