Background: Sublingual immunotherapy (SLIT) is effective and convenient for many allergic patients but it is still ineffective for many children with allergic rhinitis (AR). In previous studies, most of the patients with poor efficacy of SLIT used the method of individualized adjustment of drug dosage. Currently, there are few reports on the relationship between serum vitamin D 3 level and the efficacy of SLIT.Methods: In this study, 153 patients with AR who received SLIT were selected as the study objects. All patients collected serum for vitamin D 3 test before treatment. The clinical characteristics of the patients were collected, and all patients were regularly followed up for at least 6 months. The improvement rates were assessed according to the combined symptom medication score (CSMS). A receiver operating characteristic (ROC) curve was drawn, and the optimal cut-off point was determined according to the Youden index.Univariate and multivariate logistic regression were used to analyze the relationship between serum vitamin D 3 and SLIT efficacy. The odds ratios (ORs) and 95% confidence intervals (CIs) were computed by logistic regression.Results: Of 153 AR patients, 101 patients entered the final statistical analysis. According to CSMS, 29.7% of patients in low response (LR) group. The mean vitamin D 3 level was (20.42±7.48) ng/mL. The optimal cutoff point for vitamin D 3 was 22.25 ng/mL. Univariate logistic regression analysis of SLIT efficacy showed that whether the patient also had a food allergy (P<0.001) or asthma (P=0.011), whether they used acarid products (P=0.002), and whether vitamin D 3 is sufficient (P=0.001) were significantly related to the efficacy of SLIT. Multivariate logistic regression analysis showed that after adjusting for whether the patient also had asthma and whether they had used acarid products, whether the patient also had a food allergy (OR: 12.13, 95% CI: 3.57-41.18, P<0.001) and whether vitamin D 3 is sufficient (OR: 22.21, 95% CI: 4.04-122.30, P<0.001) were independent factors affecting the efficacy of SLIT.Conclusions: Serum Vitamin D 3 deficiency can affect the efficacy of SLIT in children with AR. This study provided a new therapeutic approach for SLIT patients with poor efficacy.
Background: Sublingual immunotherapy (SLIT) is an effective approach for treating allergic rhinitis in children. Although the curative effect of SLIT is significant, the compliance of patients is poor because of the long treatment time. How to improve patients' compliance with SLIT is an important clinical problem faced by otolaryngology clinicians. At present, there are few studies on SLIT compliance. The present study aimed to analyze the related factors affecting SLIT compliance in children with AR.Methods: In total, 153 patients with AR who received SLIT were selected as the study objects. 17 patients were excluded from this study.The patients' demographic, follow-up methods, complications efficacy, compliance data, etc. were collected, and all patients were followed-up regularly. Patients were considered to have poor compliance when they stop taking medication of SLIT. Univariate and multivariable regression analyses were performed to analyze the independent factors influencing SLIT compliance. The odds ratios (ORs) and 95% confidence intervals (CIs) were computed by logistic regression.Results: A total of 136 patients were enrolled in this study. The baseline clinical factors of the two groups of follow-up methods were balanced and comparable. Among these, 35 patients (25.7%) ceased SLIT. There was a significant difference in compliance between the Internet follow-up group and the traditional follow-up group (P<0.001). Univariate logistic regression analysis showed that SLIT compliance was significantly related to residence (P<0.001), the caregiver's education level (P<0.001), follow-up methods (P<0.001), and whether the patient also had asthma (P<0.002). In the multivariate regression analysis, it was found that the follow-up methods (OR =7.60, 95% CI: 2.20-26.21, P=0.001) and caregiver's education level (OR =8.54, 95% CI: 3.04-23.95, P<0.001) were independent factors influencing SLIT compliance after adjusting for residence and whether the patient also had asthma.Conclusions: Our study found that the follow-up methods and the education level of caregivers were independent factors affecting SLIT compliance in children with AR. This study suggested that we should use the Internet follow-up method for children treated with SLIT in the future, and provides a basis for how to improve the compliance of SLIT in children with AR.
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