Safety and Efficacy of Radioallergosorbent Test‐Based Allergen Imunotherapy in Treatment of Perennial Allergic Rhinitis and Asthma

Yeoh, Kian Hian; Wang, De Yun; Gordon, Bruce R.

doi:10.1016/j.otohns.2004.04.020

Cited by 6 publications

(5 citation statements)

References 16 publications

(25 reference statements)

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“…Second, the relevant measure by which allergy tests should be judged is the patient’s clinical response to AIT based on their test results [ 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Intradermal Testing Doubles Identification of Allergy among 110 Immunotherapy-Responsive Patients with Eustachian Tube Dysfunction

et al. 2021

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The purpose of this study was to determine whether the sensitivity advantage of intradermal dilutional testing (IDT) is clinically relevant in patients with obstructive Eustachian tube dysfunction (ETD) or otitis media with effusion (OME). This retrospective, private-practice cohort study compared the sensitivity of skin prick tests (SPT) vs. IDT in 110 adults and children with suspected allergy and OME. Primary outcome measure was symptom resolution from allergy immunotherapy (AIT). IDT identified 57% more patients as being allergic, and 8.6 times more reactive allergens than would have been diagnosed using only SPT. Patients diagnosed by IDT had the same degree of symptom improvement from immunotherapy, independent of allergen sensitivity (66% by SPT vs. 63% by IDT; p = 0.69, not different). Low-sensitivity allergy tests, which may fail to identify allergy in over two thirds of children aged 3 to 15 as being atopic, or among 60% of patients with ETD, may explain why many physicians do not consider allergy as a treatable etiology for their patient’s OME/ETD. IDT offers superior sensitivity over SPT for detecting allergens clinically relevant to treating OME/ETD. These data strongly support increased utilization of intradermal testing and invite additional clinical outcome studies.

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“…Second, the relevant measure by which allergy tests should be judged is the patient’s clinical response to AIT based on their test results [ 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Intradermal Testing Doubles Identification of Allergy among 110 Immunotherapy-Responsive Patients with Eustachian Tube Dysfunction

et al. 2021

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“…The first is that this study was of a large group of 371 multi-symptomatic allergy patients who were assessed by comparing each patient's own pre-treatment and post-maintenance therapy symptom scores (Table 1). The relevant measure by which allergy tests should be judged is the patient's clinical response to AIT based on their test results [10][11][12]. To our knowledge, no large study has previously compared IDT and SPT methods using treatment outcomes based on the actual test results.…”

Section: Study Strengthsmentioning

confidence: 99%

“…It has proven difficult to demonstrate that adding IDT produces therapeutic gain. Any such benefit must be judged by patients' superior response to AIT based on their particular test results [10][11][12]. Prior efforts to compare SPT and IDT have had insufficient populations to validly compare AIT outcomes [13,14].…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion

Hurst

McDaniel

2021

Cells

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Background: We evaluated the value of positive intradermal dilution testing (IDT) after negative skin prick tests (SPT) by retrospectively determining allergy immunotherapy (AIT) outcomes. Methods: This private practice, cohort study compared the relative value of SPT vs. IDT in 371 adults and children with suspected manifestations of allergy: chronic allergic rhinitis (AR), asthma and/or chronic otitis media with effusion (OME). The primary outcome measure was symptom resolution following immunotherapy, as determined by symptom severity questionnaires completed by patients before and after AIT. Results: Positive IDT identified 193 (52%) patients who would not otherwise have been diagnosed. IDT detected 3.7-fold more allergens per patient than SPT (8.56 vs. 2.3; p < 0.01). Patients positive only on IDT responded to AIT equally well as those identifiable by SPT, independent of allergen sensitivity (67% by SPT vs. 62% by IDT; p = 0.69, not significantly different). Conclusion: Intradermal titration can identify patients who will benefit from allergy immunotherapy more accurately than SPT. Outcomes analysis in 371 patients shows that IDT doubled their chance of successful treatment with no greater risk of therapeutic failure. Positive IDT, following negative SPT, is clinically relevant and offers superior sensitivity over SPT for detecting allergens clinically relevant to diagnosis of AIT-responsive atopic disease.

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“…Our recent SCIT study included 480 patients among whom 384 had PAR and 96 PAR and asthma [67]. HDM (Der p and Der f) sensitivity was present in 98% of these patients and was the primary allergic problem for most.…”

Section: Allergen‐specific Immunotherapymentioning

confidence: 99%

Management of persistent allergic rhinitis in the tropics: Singapore experiences

Gordon

2008

Clin Exp All Rev

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Allergic rhinitis (AR) is a common manifestation of allergic diseases, affecting X10-25% of the world's population. In the tropics, the majority of AR is persistent. The year-round warm, humid climate is conducive for the proliferation of dust mites and moulds, two of the most common aeroallergens implicated in persistent allergic rhinitis (PAR). The management of AR includes patient education, allergen avoidance, pharmacological treatment, and specific immunotherapy. Patient education, especially regarding dust and mould exposure reduction, can be effective but is often under-utilized. Second generation, non-sedating H 1antihistamines rapidly relieve most nasal symptoms because they effectively block the histamine H 1 -receptors that trigger plasma exudation and oedema. Congestion is most effectively controlled by intranasal glucocorticosteroids (INSs), which are currently the most potent AR drug treatment. The beneficial effects of steroids depend on their long-term, multipathway anti-inflammatory effects, unlike H 1 -antihistamines, which directly block neural and vascular H 1 receptors. However, especially in PAR, patients' compliance with INS therapy has a significant impact on treatment efficacy, because year-round treatment is required. Subcutaneous inhalant allergen immunotherapy (SCIT) is effective against a broad range of AR symptoms, and may be able to alter the natural course of allergy and prevent asthma onset. SCIT can significantly reduce the severity of allergic disease, including nasal obstruction, and decrease the need for anti-allergic drugs. Immunotherapy (IT) can also be given as sublingual drops (SLIT). Recent studies have shown the SLIT to be effective in reducing AR symptoms and medication use. Both types of IT require long-term patient compliance for successful treatment. Drug and IT interventions may not be economically feasible in certain patients. In conclusion, the type of AR most prevalent in the tropics is PAR, which must be treated year round. Improvement of educational programmes for the public and physicians alike seems to be the most effective treatment strategy.

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Safety and Efficacy of Radioallergosorbent Test‐Based Allergen Imunotherapy in Treatment of Perennial Allergic Rhinitis and Asthma

Abstract: C.

Cited by 6 publications

References 16 publications

Intradermal Testing Doubles Identification of Allergy among 110 Immunotherapy-Responsive Patients with Eustachian Tube Dysfunction

Intradermal Testing Doubles Identification of Allergy among 110 Immunotherapy-Responsive Patients with Eustachian Tube Dysfunction

Clinical Relevance and Advantages of Intradermal Test Results in 371 Patients with Allergic Rhinitis, Asthma and/or Otitis Media with Effusion

Management of persistent allergic rhinitis in the tropics: Singapore experiences

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