A controlled trial of immunotherapy for asthma in allergic children
A controlled trial of immunotherapy for asthma in allergic children
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DOI：
10.1056/nejm199701303360502
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发表时间：
1997-01-30
影响因子：
158.5
通讯作者：
Wheeler, B
中科院分区：
文献类型：
--
作者：
Adkinson, NF;Eggleston, PA;Wheeler, B
背景注射过敏原被广泛规定为哮喘患者，但鲜为人知的是免疫治疗的有效性。方法我们进行了一项双盲，安慰剂对照试验的多过敏原免疫治疗在121过敏儿童中度至重度，常年（全年）哮喘。这些儿童每天需要服用哮喘药物，他们被随机分配接受皮下注射最多七种空气过敏原提取物的混合物或安慰剂。维持注射持续18个月或更长时间。根据峰值流速和症状，每两到三周调整一次药物。主要结局是每日用药评分。结果免疫治疗组的药物敏感性评分中位数从5.4分下降到4.9分（P <0.5），免疫治疗组的药物敏感性评分中位数从5.4分下降到4.9分（P <0.5）。两组在医疗护理、症状或峰值流速方面没有差异。中位PC20显着增加，在这两组中，但再次与两组之间没有差异。结论免疫治疗注射过敏原超过两年是没有明显的好处，常年性哮喘的过敏性儿童接受适当的药物治疗。(C)1997年，马萨诸塞州医学会。
Background Injections of allergens are widely prescribed for patients with asthma, but little is known about the effectiveness of immunotherapy.Methods We conducted a double-blind, placebo-controlled trial of multiple-allergen immunotherapy in 121 allergic children with moderate-to-severe, perennial (year-round) asthma. The children, who required daily medication for their asthma, were randomly assigned to receive subcutaneous injections of either a mixture of up to seven aeroallergen extracts or a placebo. Maintenance injections were continued for 18 months or longer. Medications were adjusted every two to three weeks on the basis of peak flow rates and symptoms. The principal outcome was the daily medication score. Bronchial sensitivity to methacholine (the concentration provoking a 20 percent decrease in the forced expiratory volume in one second [PC20]) was measured twice yearly.Results The median medication score declined from 5.4 to 4.9 in the immunotherapy group (P0.5). There was no difference between the groups in the use of medical care, symptoms, or peak flow rates. The median PC20 increased significantly in both groups, but again with no difference between the two groups.Conclusions Immunotherapy with injections of allergens for over two years was of no discernible benefit in allergic children with perennial asthma who were receiving appropriate medical treatment. (C) 1997, Massachusetts Medical Society.