Steroid-sparing effect of subcutaneous SQ-standardised specific immunotherapy in moderate and severe house dust mite allergic asthmatics
Steroid-sparing effect of subcutaneous SQ-standardised specific immunotherapy in moderate and severe house dust mite allergic asthmatics
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DOI：
10.1111/j.1398-9995.2006.01088.x
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发表时间：
2006-07-01
期刊：
影响因子：
12.4
通讯作者：
Dahl, R.
中科院分区：
文献类型：
--
作者：
Blumberga, G.;Groes, L.;Dahl, R.
背景：本研究评价了SQ标准化皮下特异性免疫疗法(SIT)对中、重度屋尘螨(HDM)过敏性哮喘的脱毒作用。方法：54例对HDM过敏的成人哮喘患者，每天至少吸入等量的皮质类固醇(ICS)，随机分为SIT组和安慰剂组，疗程为3年。分别于治疗前、治疗后1、2、3年进行最低ICS用量、4周哮喘症状记分、抢救药物使用、呼气峰流速(PEF)测定和哮喘症状视觉模拟评分。结果：中、重度哮喘患者ICS治疗2年后下降有统计学意义(P=0.03)，3年后下降不明显。第三年后，主动组和安慰剂组的中位数分别减少了82%和42%。在中度持续性哮喘患者中，接受SIT治疗的患者在2年和3年后的降幅与安慰剂相比有统计学意义。3年后SIT的中位降幅为90%，安慰剂为42%(P=0.04)。尽管类固醇显著减少，但两组之间的哮喘评估没有差异。未见与SIT注射相关的严重反应。结论：本研究表明SQ标准化HDM提取物的SIT是安全的。在中度持续性哮喘患者中，ICS节制效果明显。
Background: The present study evaluated the steroid-sparing effect of subcutaneous SQ-standardized specific immunotherapy (SIT) in moderate and severe house dust mite (HDM) allergic asthmatics.Methods: Fifty-four adult asthmatics allergic to HDM requiring at least inhaled corticosteroids (ICS) doses equivalent to 500 mu g fluticasone propionate daily were randomized to subcutaneous SIT or placebo injections for a period of 3 years. The minimum required ICS dose, 4 week diary of asthma symptom score, use of rescue medication, peak expiratory flow (PEF) measurements and visual analog scale for asthma symptoms were assessed before start of treatment and after 1, 2 and 3 years of treatment.Results: In patients with moderate and severe asthma, the reduction in ICS was statistical significant after 2 years of treatment (P = 0.03) but not after 3 years. The median reductions were 82% and 42% after the third year for active and placebo respectively. In patients with moderate persistent asthma the reduction was statistical significant larger for those treated with SIT compared with placebo after year 2 and year 3. The median reductions after 3 years were 90% for SIT and 42% for placebo (P = 0.04). Despite significant steroid reduction, there was no difference in asthma assessments between the two groups. No serious reactions related to SIT injections were seen.Conclusion: This study shows that SIT with a SQ-standardized HDM extract is safe. An ICS sparing effect was evident in patients with moderate persistent asthma.