Patient management plan for sublingual allergen specific immunotherapy with birch pollen allergen and the maintenance of patient compliance

2020 ◽  
Vol 17 (3) ◽  
pp. 64-73
Author(s):  
Olga V. Trusova ◽  
Andrey V. Kamaev ◽  
Irina V. Makarova
Keyword(s):  
Side Effects ◽  
Patient Management ◽  
Specific Immunotherapy ◽  
Birch Pollen ◽  
Management Plan ◽  
Allergen Specific Immunotherapy ◽  
Treatment Termination ◽  
Birch Pollen Allergen ◽  
Retention In Treatment ◽  
Patient Retention

BACKGROUND:Sublingual allergen-specific immunotherapy (SLIT) inefficiencie is mainly caused by non-compliance with the treatment regimen and premature treatment termination. AIM:Frequency and causes of dropouts determination in children receiving SLIT with birch pollen according to the pre-coseasonal protocol, and approbation of the developed visit-to-visit patient management plan (Plan). MATERIALS AND METHODS:332 cases of treatment with birch pollen in children are analyzed. 290 patients (72.1% boys, aged 518 years (9.82 years [5.93; 14.67]), received SLIT with birch pollen in 20122019. 42 patients received SLIT according to the Plan (69% boys, 8.95 years old [5.38; 11.79]) in 20172019. RESULTS:A low dropout frequency was noted in the 1st and 2nd year of therapy (2 years after the start of treatment, 85% patients continue it). However, only 63.1% complete 3 years of therapy, and 11% 4 years of therapy. It has been shown that experienced allergists have more efficient patient retention. The implementation of the Plan increased patient retention in treatment at the 3rdyear of treatment up to 82.9% (p=0.02). CONCLUSION:The study confirmed the main reasons for the withdrawal of patients from SLIT: doubts about the effectiveness, cost and side effects. A low dropout frequency was shown according to the results of the 1stand 2ndyears of therapy, but only a small proportion of patients (11%) receive 4 or more courses of therapy. Visit-to-visit Plan optimizes the patients management, reduces patients withdrawal from treatment and can be recommended for practical healthcare.

scholarly journals Patient dropouts from sublingual allergen specific immunotherapy with house dust mites. Solving a problem.

2020 ◽  
Vol 17 (2) ◽  
pp. 53-60
Author(s):  
Olga V. Trusova ◽  
Andrey V. Kamaev ◽  
Irina V. Makarova
Keyword(s):  
House Dust ◽  
Patient Management ◽  
Specific Immunotherapy ◽  
Low Frequency ◽  
Management Plan ◽  
Drop Out ◽  
House Dust Mites ◽  
Treatment Withdrawal ◽  
Dust Mites ◽  
Allergen Specific Immunotherapy

Relevance. The insufficient effect of sublingual allergen-specific immunotherapy (SLIT) is caused, first of all, by non-compliance with the treatment regimen and premature treatment termination. Purpose of the study. Determining the frequency of patient drop-out rate during SLIT with house dust mites (HDM) allergens in children with allergic rhinitis (AR) or AR in combination with bronchial asthma (BA), with an analysis of the drop-out reasons, and approbation of the developed visit-to-visit patient management plan (Plan). Materials and methods. We analyzed 274 cases of treatment with HDM SLIT in children. 218 patients: 67.4% (147) boys, median age 11.33 years [7.26; 15.46], the proportion of patients with BA 43.1% (94 children) received HDM SLIT in 20132020. 56 patients: 71.4% (40) boys, median age 9.29 years [6.13; 15.93], the proportion of patients with BA 78.6% (44 children) received treatment in accordance with the Plan. Results. A relatively low frequency of treatment withdrawal was noted in the first 2 years of therapy (2 years after the start of treatment, 72.47% patients continue it). However, only 52.29% complete 3 years of therapy, and 14.67% complete 4 years of therapy. Implementation of the Plan increased patient retention in treatment at the 3rd year of treatment to 69.64% (p=0.031). Conclusions. Only half of the patients receive the required three-year minimum of treatment. The daily plan optimizes the patient management schedule for HDM ASIT; reduces patient dropout from treatment and can be recommended for practical healthcare.

scholarly journals Preparation and Characterization of a Glycyrrhizic Acid-Based Drug Delivery System for Allergen-Specific Immunotherapy

2021 ◽  
Author(s):  
Ekaterina Pashkina ◽  
Veronika Evseenko ◽  
Natalya Dumchenko ◽  
Maxim Zelikman ◽  
Alina Aktanova ◽  
...  
Keyword(s):  
Side Effects ◽  
Delivery System ◽  
Glycyrrhizic Acid ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Treg Cells ◽  
Delivery Systems ◽  
New Drugs ◽  
Allergen Specific Immunotherapy

The most effective method of treating allergic diseases, aimed not at relieving symptoms, but at eliminating the cause of the disease, is allergen-specific immunotherapy (AIT). To reduce the risk of side effects and improve the delivery of allergens to the mucosa, various delivery systems, such as liposomes, dendrimers, nanoparticles, etc., can be used. To date, there are data on the creation of delivery systems based on glycyrrhizic acid (GA) and its derivatives, but such a delivery system has not been used for allergen-specific therapy until now. At the same time, it is known that GA has an anti-inflammatory effect, shifts the balance towards Th1, and increases the number of Treg cells, which means that in the future it can enhance the anti-allergic effect of AIT and reduce the risk of unwanted side effects. Thus, the study of the immunomodulatory effect of supramolecular complexes (micelles) of GA with extracts of allergens seems to be very promising for the development of new drugs for AIT.

scholarly journals Standardized Quantitative Evaluation of Clinical Effectiveness and Side Effect Profile of Subcutaneous and Sublingual Allergen-Specific Immunotherapy in Children: A 5-Year Single Center Experience

2021 ◽  
Vol 19 (3) ◽  
pp. 156-165
Author(s):  
Nazan TÖKMECI ◽  
Ali DEMIRHAN ◽  
Merve TURKEGUN SENGUL ◽  
Burcu CAGLAR YUKSEK ◽  
Aylin KONT ÖZHAN ◽  
...  
Keyword(s):  
Side Effects ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Visual Analog Score ◽  
Allergen Specific Immunotherapy ◽  
Medication Score ◽  
Asthma Patients ◽  
Systemic Side Effects ◽  
High Responders

Objective: Allergen-specific immunotherapy (allergen-SIT) is a treatment method with variable efficacy in allergic diseases. This study aimed to investigate the effectiveness of allergen immunotherapy, frequency of LRs and SRs and variables affecting these parameters in patients who underwent allergen-SIT. Materials and Methods: In this study, the recorded data of 81 patients, who received subcutaneous (SCIT) or sublingual (SLIT) allergen immunotherapy for respiratory allergic diseases between 2014 and 2019, were analyzed. In asthma and/or allergic rhinoconjunctivitis (ARC) patients, the effectiveness of treatment was evaluated by analysing the change rates in disease symptom, medication and combined scores (symptom + medication) and visual analog score (VAS). Treatment success was defined by the degree of decrease in scores as; high response above 50%; low response between 20-50%; and failure <20%.Results: The mean age of allergen-SIT initiation was 11.4± 3.1 years. Diagnostic distributions of the patients were asthma (± ARC) in 64.2%, and ARC (without asthma) in 35.8%. The mode of allergen-SIT was SCIT in 77.8% (65% asthma and 35% ARC) and SLIT in 22.2% (61.1% asthma and 38.9% ARC). The main allergens used in allergen-SIT were mite (79%), grass-grain pollen (33.3%), alternaria (9.9%) and olea (8.6%). There was a significant decrease in symptoms, medication, combined and VAS scores in the asthma and ARC groups (p <0.0001), when end-SCIT values were compared to baseline. SLIT also resulted in significant decreases in these scores except asthma medication score. Among the asthma patients the rate of high-responders was 88.8% by SCIT and 50% by SLIT, according to combined asthma score. Among the ARC (without asthma) patients the rate of high-responders was 100% for both SCIT and SLIT. SCIT resulted in local (LR) and systemic side effects (SR) in 18% and 0.6% (all Grade I and Grade II) of the total injections performed. A high number of total injections was significantly associated with higher LR and SR rates. While LR was observed in 16.6% of the patients who underwent SLIT, no systemic reaction was found in any of the patients. Conclusion: SCIT was highly successful in the treatment of asthma and ARC in terms of the degree of therapeutic response. SLIT resulted in a high rate of good response in ARC patients, but a lower response degree in asthmatic patients. Systemic side effects were very low as a result of close risk monitoring and the dose adjustments performed. Keywords: Allergen-specific immunotherapy, SCIT, SLIT, efficacy, symptom score, medication score, visual analog score, side effects

Birch pollen allergic patients undergoing allergen specific immunotherapy also respond to minor allergen Bet v 2

2007 ◽  
Vol &NA; ◽  
pp. S237
Author(s):  
Morten Svenson ◽  
Uffe Bodtger ◽  
Lars K Poulsen ◽  
Mercedes Ferreras ◽  
Jorgen N Larsen
Keyword(s):  
Specific Immunotherapy ◽  
Birch Pollen ◽  
Allergen Specific Immunotherapy ◽  
Minor Allergen

IgE and allergen-specific immunotherapy-induced IgG4recognize similar epitopes of Bet v 1, the major allergen of birch pollen

2016 ◽  
Vol 47 (5) ◽  
pp. 693-703 ◽  
Author(s):  
N. Groh ◽  
C. S. von Loetzen ◽  
B. Subbarayal ◽  
C. Möbs ◽  
L. Vogel ◽  
...  
Keyword(s):  
Specific Immunotherapy ◽  
Birch Pollen ◽  
Major Allergen ◽  
Allergen Specific Immunotherapy ◽  
Bet V 1
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