sublingual immunotherapy
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2022 ◽  
Author(s):  
Ru Chen ◽  
◽  
Yao Sun ◽  
Guoqi Sima

Review question / Objective: What is the effect of intralymphatic, subcutaneous and sublingual immunotherapy for pollen-induced allergic rhinitis. Condition being studied: Immunotherapy is the classic treatment for allergic rhinitis. Intralymphatic immunotherapy is a new type of treatment. Currently, no studies have compared subcutaneous, sublingual and intralymphatic sublingual immunotherapy. At present, there is no review to compare the efficacy of intralymphatic, subcutaneous and sublingual immunotherapy for pollen-induced allergic rhinitis.


2022 ◽  
Vol 2 ◽  
Author(s):  
Huan Chen ◽  
Guo-qing Gong ◽  
Mei Ding ◽  
Xiang Dong ◽  
Yuan-li Sun ◽  
...  

Purpose: Both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are effective in reducing symptoms and medication scores and inducing long-term efficacy in patients with allergic rhinitis (AR). However, SLIT has been associated with poor patient adherence. This study investigates the factors impacting dropout rates from SLIT in house dust mite (HDM)-sensitized AR patients.Methods: A retrospective study was performed to analyze dropout rates and reasons in AR patients receiving Dermatophagoides farinae (Der f) SLIT with a follow-up period of 2 years.Results: A total of 719 HDM-sensitized AR patients received Der f-SLIT. Dropout rates increased with time and most occurred after 1 year of SLIT. By month 24, 654 (91%) patients had discontinued SLIT. The dropout rates by month 24 were 100, 90.1, and 91.1% in children <5 years old, children aged 5–18 years old, and adults ≥ 18 years old, respectively. Combination with allergic asthma and mono- or multi-sensitization to other aeroallergens did not affect the dropout rates. The most common self-reported reasons for dropouts were refusal of continuation, dissatisfaction with the efficacy, transition to SCIT, and adverse effects. Refusal of continuation increased with age, whereas transition to SCIT decreased with age. Ninety-seven cases transitioned from SLIT to SCIT, and the transition rates increased with time. Comorbid allergic asthma did not affect the transition rates. However, multi-sensitization was associated with a slightly higher rate of transition to SCIT. The most common reason for the transition was dissatisfaction with the efficacy (54.6%), which was only reported by patients older than 5 years. For children who began SLIT at younger than 5 years old, the most common reason (81.2%) for transition was age reaching 5 years.Conclusions: HDM-SLIT has a very high dropout rate, which is mainly due to refusal of continuation and dissatisfaction with the efficacy. Transitioning from SLIT to SCIT may help keep these patients on AIT and thus increase adherence and long-term efficacy.


2021 ◽  
Vol 12 (4) ◽  
pp. 35-43
Author(s):  
D. S. Korostovtsev ◽  
O. V. Trusova ◽  
A. V. Kamaev

Background. For practical health care, tools for assessing the effect of allergen-specific immunotherapy have not been developed. Aim. Approbation of the system for evaluating the effectiveness of sublingual immunotherapy with house dust mite allergens in patients with bronchial asthma with allergic rhinitis. Materials and methods. 28 cases of sublingual immunotherapy treatment in patients aged 5 to 13 years, (8,6 [6,7; 11,6]) with control in pairs-copies matched by age, sex, and asthma severity were analyzed. Thus, the study included 56 patients. Patients in the control group did not receive sublingual immunotherapy. For 1 year before the start of treatment, and for the first year of treatment, the complex of clinical signs of bronchial asthma and allergic rhinitis, the need for basic and emergency therapy was assessed. The scores were calculated for symptoms, for drugs, and a total Score of symptoms and drugs. Results. During 1 year of therapy, patients showed dynamics of the total Score from 23,32 1,21 points to 16,21 1,77 in the main group, and from 23,99 1,2 points to 20.92 2.09 in control group (p = 0.028). The greatest difference was found within medication domain. Conclusion. The developed system for assessing the symptoms and the need for medications makes it possible to show the difference between groups of patients, in favor of the sublingual immunotherapy group. For 1 year of sublingual immunotherapy therapy, a difference in the total Score dynamics and the domain of drugs was revealed between the groups. The proposed assessment system is recommended for further investigation.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Anne K. Ellis ◽  
Remi Gagnon ◽  
David I. Bernstein ◽  
Hendrik Nolte

Abstract Background Post hoc analyses of randomized placebo-controlled trials have demonstrated efficacy and tolerability of the ragweed sublingual immunotherapy (SLIT)-tablet in Canadian adults with ragweed pollen-induced allergic rhinitis/conjunctivitis (AR/C). This post hoc analysis evaluated the efficacy and tolerability of the ragweed SLIT-tablet in the subpopulation of Canadian children and adolescents with AR/C in a previously described randomized, double-blind, placebo-controlled trial. Methods The trial (NCT02478398) was conducted in North American and European children/adolescents ages 5–17 years with ragweed pollen-induced AR/C with or without asthma (FEV1 ≥ 80% predicted). Participants were randomized to daily ragweed SLIT-tablet (12 Amb a 1-U) or placebo for up to 28 weeks. The primary endpoint was the average total combined score (TCS; sum of rhinoconjunctivitis daily symptom score [DSS] and daily medication score [DMS]) during peak ragweed pollen season (RPS). Key secondary endpoints were TCS during the entire RPS, and DSS and DMS during peak RPS. Post hoc analyses of the primary and key secondary endpoints were conducted in the subpopulation of Canadian participants. Results Of the 1025 randomized participants, 246 (SLIT-tablet, n = 116; placebo, n = 130) were in the Canadian subpopulation. In the total study population, relative TCS (95% CI) improvement with ragweed SLIT-tablet versus placebo was − 38.3% (− 46.0%, − 29.7%; least square [LS] mean difference, − 2.73; P < 0.001) during peak RPS. In the Canadian subpopulation, relative TCS improvements with ragweed SLIT-tablet versus placebo were − 40.8% (− 54.5%, − 20.2%; LS mean difference, − 1.59; P = 0.001) during peak RPS and − 36.6% (− 50.2%, − 16.5%; LS mean difference, − 1.36; P = 0.002) during the entire RPS. DSS and DMS during peak RPS in the Canadian subpopulation improved with SLIT-tablet versus placebo by − 30.6% (− 45.2%, − 7.7%; LS mean difference, − 0.94; P = 0.010) and − 77.2% (− 97.5%, − 44.2%; LS mean difference, − 0.66; P = 0.003), respectively. No events of anaphylaxis, airway compromise, intramuscular epinephrine administration, eosinophilic esophagitis, or severe treatment-related systemic allergic reactions were reported in the overall population or Canadian subpopulation. Conclusion Efficacy and safety of the ragweed SLIT-tablet in Canadian children/adolescents with ragweed pollen-induced AR/C was consistent with the total study population. The ragweed SLIT-tablet resulted in clinically meaningful improvement in symptoms, decreased symptom-relieving medication use, and was well tolerated in Canadian children/adolescents. Trial registration: clinicaltrials.gov, NCT02478398. Registered June 23, 2015, https://clinicaltrials.gov/ct2/show/NCT02478398?term=NCT02478398&draw=2&rank=1


Author(s):  
Madonna Nader Adly ◽  
Mahmoud Fawzy Mandour ◽  
Mahmoud Foad Abd Elaziz ◽  
Magdy Eisa Saafan

Background: Allergic rhinitis is a common disease that affect nose causing sneezing, watery nose, nasal itching and redness that affect quality of life, productivity at work or school and may underlies complications (e.g. Asthma) for patients and are often accompanied by itchy eye, redness and lacrimation. Aim of the Work: The objective of this study is to systematically assess the efficacy and safety of immunotherapy treatment for patients with Allergic Rhinitis. Method: Our initial search generated a total of 23330 possible relevant titles. Titles, abstracts were preliminary screening so that 22565 were excluded. 154 articles were retrieved in full text the number of studies excluded after assessment of the full text 145, 9 articles met the eligibility criteria and fulfilled the inclusion and exclusion criteria for the review. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available on the Internet upto 2018. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion: Our systematic review provides evidence that Sublingual Immunotherapy (SLIT) tablets effectively relieve rhinitis symptoms in adults with allergic rhinitis, improve their quality of life and provide data about safety of Sublingual Immunotherapy as there were no serious side effects of using SLIT tablets. Nevertheless, the current evidence may be limited due to sample size and the heterogeneity between studies. Large sample size and multiple center RCTs on the efficacy of different formulations of SLIT drugs are still needed to provide further evidence and more precise recommendations.


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