Quality of life improvement after a three-year course of sublingual immunotherapy in patients with house dust mite and grass pollen induced allergic rhinitis: results from real-life

Abstract

BackgroundAlong with its high prevalence, the burden of allergic rhinitis rests upon the serious impact on quality of life of patients. Allergic rhinitis is associated with impairments in daily activities, work and school performance, and practical problems. Patients suffer from sleep disorders and emotional problems. Тhe advantages of sublingual immunotherapy on quality of life have only recently begun to emerge. The objective of this prospective real-life study was to evaluate the effect of a three-year course of sublingual immunotherapy with house dust mite (HDM) and grass pollen extracts on quality of life in adults with allergic rhinitis.MethodsA total number of 191 adult patients [105 (54,979%) men; mean age 27.3 years (SD-6.14)] with moderate to severe allergic rhinitis and clinically relevant sensitization to house dust mites or grass pollen were prospectively evaluated in the course of management of their disease. Health-related quality of life was assessed by Rhinoconjunctivitis Quality of Life Questionnaire at baseline and after three-year course of sublingual immunotherapy.ResultsThe mean overall Qol score assessed at baseline and at the end of the third year of treatment decreased significantly in patients treated with HDM extract (from 2.95 to 0.76) as well as with Grass pollen extract (from 2.83 to 1.22) (р < 0.001). The improvements in treated with HDM extract were as followed: activities – 3.52 to 0.68; sleep- 2.48 to 0.31; general problems – 1.79 to 0.49; practical problems – 3.57 to 0.68; nasal symptoms – 3.91 to 0.74; eye symptoms – 2.92 to 0.39; emotions – 3.03 to 0.39. The improvements in grass pollen group were: activities – 3.68 to 1.69; sleep- 1.85 to 0.84; general problems – 1.74 to 0.97; practical problems – 3.52 to 1.37; nasal symptoms – 3.72 to 1.57; eye symptoms – 3.58 to 1.3; emotions – 2.48 to 1.19.ConclusionOur study conducted in real life provided evidence that a three-year course of SLIT with HDM extract as well as with grass pollen extract significantly increased QoL in patients with allergic rhinitis.

Quality of life improvement with allergen immunotherapy treatment in patients with rhinoconjunctivitis in real life conditions. Results of an observational prospective study (ÍCARA)

“…Several validated tools for assessing HRQoL in AR are currently available (30). The most frequently used specific and validated instrument, involved in AIT trials is the RQLQ questionnaire (23,26,27). Moreover, only the RQLQ allows calculating the MID, namely how much a score must change so that it is perceived as such by the patient, irrespective of its statistical significance (31).…”

“…Currently, a number of studies with AIT have been reported, where the improvement in HRQoL is evaluated mostly as a secondary efficacy variable (19,20,21,22). These studies had shown positive results in HRQoL, but most are clinical trials with sublingual immunotherapy (SLIT), and data from real life studies are still scarce (23,24). Therefore, there is still a need for more clinical evidence, specially with non-interventional studies, where a higher representation of patient's population can be included, as children, patients with comorbidities, etc.…”

Allergic reactions after vaccination: translating guidelines into clinical practice

“…The results showed that SLIT approximately halved the symptom-medication scores compared to the score registered in drug-treated patients. Since then, several real-life studies were performed, including 11 studies on SCIT (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), 15 on SLIT (6,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and 5 on both (30-…”

“…The rates of avoidance in mono-allergen, pollen-mixture and 2-simultaneous-allergen SLIT were 93.6, 83.3 and 73.7%, respectively. A significantly higher avoidance (p = 0.0001) was observed in children with longer-duration SLIT (28). Another aspect evaluated in a single study was the ability to prevent the development of asthma in subjects treated for AR.…”

Cross-cultural adaptation and validation of the RhinAsthma Patient Perspective (RAPP) in the Polish population

“…The available data indicate that AR and asthma markedly affect the physical, emotional and social dimensions of patients' experience [7,8]. This is supported by evi-dence that successful treatment of respiratory allergy improves the HRQoL [9][10][11][12][13].…”