Clinical Efficacy of Allergen-Specific Immunotherapy from Patient and Physician Perspectives

Abstract

Purpose Allergen-specific immunotherapy (AIT) is the only curative treatment for allergic diseases, but a few allergic patients receive AIT. In this multicenter cross-sectional study, we aimed to explore patient and physician perspectives on AIT through a questionnaire survey. Materials and Methods Allergic patients who received subcutaneous immunotherapy for at least 1 year were asked to answer a questionnaire developed by an expert panel of allergen and immunotherapy workgroup in Korea. Results A total of 267 patients (adults, 60.3%) with allergic rhinitis (91.4%), asthma (42.7%), or atopic dermatitis (20.2%) from referred hospitals completed the survey. Among patients and physicians, respectively, the overall rates of satisfaction with AIT for allergic rhinitis were 86.4% and 83.3% (kappa agreement=0.234, p <0.001), and those for asthma were 85.3% and 72.9% (kappa agreement=0.373, p <0.001). Moreover, pediatric asthmatic patients reported a significantly higher satisfaction rate than adult asthmatic patients after AIT ( p =0.040). Symptom severity ( p <0.001, respectively) and drug use for allergic rhinitis and asthma decreased after AIT. However, there was no significant difference in satisfaction rates between children and adults in allergic rhinitis ( p =0.736). Interestingly, 35.7% and 35% of allergic rhinitis and asthma patients, respectively, reported experiencing improvement in their symptoms within 6 months of starting AIT. Conclusion In this study evaluating the perspectives of patients and physicians on AIT, the majority of patients were satisfied with the efficacy and safety of AIT, but not its cost. AIT should be recommended for AR and allergic patients.

A real-world retrospective study of safety, efficacy, compliance and cost of combination treatment with rush immunotherapy plus one dose of pretreatment anti-IgE in Chinese children with respiratory allergies

“…Recent studies have confirmed the clinical efficacy of CIT in controlling allergy symptoms and reducing the need for medication, as well as in preventing allergic patients from developing new allergic sensitization and preventing asthma development (4,(15)(16)(17), however, it is still underused in clinical practice (2,6,18), mostly due to the inconvenience associated with weekly hospital visits during the 3-4 months initial build-up phase. In recent years, RIT with its much s h o r t e n e d u p -d o s i n g p h a s e h a s a c h i e v e d c e r t a in breakthroughs.…”

The early-phase transcriptome and the clinical efficacy analysis in three modes of subcutaneous immunotherapy for allergic rhinitis

“…Many studies have demonstrated the clinical efficacy and safety of SCIT using mite extracts, 5 , 6 , 7 and the overall response rate ranged from 52.0% to 86.4%. 8 , 9 , 10 , 11 Open questions remain regarding the selection of patients responding successfully to SCIT. Mechanisms of subcutaneous immunotherapy include inhibiting TH2 responses, decreasing activation of mast cell, basophil, and type 2 congenital lymphocytes, promoting Treg and Breg cell activation, promoting IgG4 production, and inhibiting inflammatory responses.…”

Correlation between induration diameter of skin prick test result to house dust mite allergen with immunotherapy efficacy

“…Despite the safety and success of immunotherapy, not all patients respond and experience clinical improvement. The recommended allergen-specific immunotherapy therapy for allergic rhinitis is 3-5 years and the average success rate ranges from 52 -86.4% with varying definitions of immunotherapy success (Di Lorenzo et al, 2009;Erekosima et al, 2014;Shin et al, 2019). Prediction of the response to immunotherapy in the second year can be done at month 4 of treatment, through symptom scores and treatment to determine the need for longterm therapy (Liu et al, 2020).…”