Is house dust mite spesific sublingual immunotherapy successful in termination of inhaled corticosteroid treatment in children with asthma?

Abstract

Objective: House dust mite (HDM)-specific sublingual immunotherapy (SLIT) has long-term effects contrary to pharmacotherapy in children with asthma. We aimed to study the long-term effects of SLIT on inhaled corticosteroid usage. Material and Method: Fifty-four asthmatic children who received HDM-specific SLIT for at least 3 years and were followed up for a minimum 5 years after cessation of SLIT in addition to pharmacotherapy and 23 patients who received only pharmacotherapy during the same time period were admitted in the study. SLIT and pharmacotherapy groups were evaluated retrospectively by scanning their medical records in regard to their inhaled corticosteroid (ICS) dose (μg/day), duration (month(s)/year) of ICS, and pulmonary function test (PFT) parameters. Visual analogue scores and symptom scores recorded for 6 months in their daily record cards given to them were evaluated, and dose (μg/day), and duration of ICS therapy (month(s)/year) were calculated PFTs were performed for each patient. Based on the diary card records regarding symptoms, the need for ICS and FEV1%, the patients were grouped as 37 SLIT-responders, 17 SLIT-nonresponders, 15 PT-responders, and 8 PT-nonresponders. Results: Reduction in ICS dose was significantly higher for SLIT (407±252 μg)n group in comparison to pharmacotherapy group (224±174 μg) (p=0.009). Duration of ICS usage reduced by 63% (p=0,001) in SLIT-nonresponder group, but in pharmacotherapynonresponder group it decreased by only 11% (p=0,108). Conclusion: SLIT was effective in reducing ICS dose. Duration of ICS treatment did not decrease in the course of time in PT-nonresponder group while decreased in SLIT-nonresponder group.