1,720,985 research outputs found
Sublingual immunotherapy in the context of a clinical practice improvement program in the allergological setting: results of a long term observational study.
No full textThe aim of this study was to assess the efficacy and safety of sublingual immunotherapy (SLIT) in a Clinical Practice Improvement (CPI) program carried out in allergology. The study was conducted between 1992 and 2001 using an observational type methodology in line with standard clinical practice. The program consisted of 4 basic steps: setting up. of a decision-making tree; standardization of main diagnostic and therapeutic aspects data collection; definition and evaluation of main clinical endpoints. Study patients were screened among 1508 patients with pollen and/or dust mite respiratory allergy, 350 of which, one year after having experienced a pharmacological treatment failure, were administered immunotherapy by injective (n = 111) or alternative route (n = 239). For each one of the three immunotherapy treatment groups (nasal, SLIT or injective) there was a control group of patients who, despite their poor response to pharmacological treatment, continued with pharmacological therapy alone (n = 314 in total; 68, 192 and 54 respectively). The observation of 130 SLIT patients, 106 of which were treated for at least 36 months, towards the control group evidenced that such therapy, apart from resulting efficient and particularly safe, has an unfailing protective effect against the development of asthma and new allergic sensitizations
Rhinitis and asthma co-morbidity in respiratory allergy due to house dust mite: results of an oservational open controlled parallel group study in real-life setting.
No full textBackground: Some aspects of allergic march still need to be addressed. To prevent the onset of the march is not, at present, a very realistic aim, although therapeutic instruments are available to delay and, if possible, to stop it. We attempted to clarify these points in an observational open controlled three-parallel group study in a real-life setting. Methods: 3838 patients with respiratory allergy due to house dust mite have been enrolled in this observational study. 2200 patients with rhinitis and/or intermittent or mild persistent asthma, poorly responsive to standard pharmacological therapy (SPT) were treated for three years with SPT associated or not with specific immunotherapy (SIT). Symptom medication scores, pulmonary function test (PFT) and methacholine (MCh) challenge were performed at the beginning and at the end of the study. 1638 pure rhinitics, responsive to SPT, enrolled as a control group, used self-medication (SM) on demand to assess the incidence of asthma in non-treated patients with standard therapeutic protocols. Results: 694 patients have been treated with SPT+SIT, 1506 with SPT and 1638 with SM. Co-morbidity rhinitis-asthma incidence was higher in the SM group (an overall 69.27% including asthma and bronchial hyperreactivity). Persistent rhinitis proved more often to be associated with asthma than intermittent rhinitis. Likewise, the moderate-severe forms compared to the mild ones. The addition of SIT to SPT reduced the allergic march in all patients. Conclusions: In everyday clinical practice too, SIT proves its efficacy in the treatment of allergic march. Patients with moderate-severe persistent rhinitis appear as the ideal candidates for this therapy
Preventive effect of sublingual immunotherapy in pediatric asthma. Open randomized trial
No full textLong-term comparison of the efficacy of adding sublingual immunotherapy or montelukast in birch-induced asthma
No full textThe allergic march in pollinosis: Natural history and therapeutic implications - Results of a long-term parallel controlled observational study
No full textBackground: That specific immunotherapy ( SIT) can slow the march of allergy has been confirmed in controlled clinical trials. However, an assessment of its effects in everyday life, in a large cohort of patients, might provide further useful information. Methods: This observational study comprised 3,643 patients allergic to pollens; 1,620 with pure allergic rhinitis or rhinitis and intermittent or mild-persistent bronchial asthma, responding poorly to standard pharmacological therapy (SPT), were treated for 3 years with SPT alone ( pure rhinitis, n = 890), or combined with continuous SIT ( rhinitis and asthma, n = 730). Symptom/drug scores were recorded, respiratory function and skin tests were done, and methacholine challenge was scheduled at the beginning and end of the study. A series of 2,023 patients with pure rhinitis, responsive to SPT, were asked to 'self-medicate' as needed, serving as a control group to check the incidence of asthma. Results: The incidence of rhinitis-asthma comorbidity was highest in the self-medication group (50.8%). Persistent rhinitis was associated with asthma more often than the intermittent form, regardless of the severity of the symptoms that led to progression to asthma in patients with intermittent rhinitis. Treatment with SIT combined with SPT always slowed the allergic march which, however, was not influenced by drugs alone. Conclusions: In routine clinical practice, SIT is effective in preventing the allergic march. Patients with persistent rhinitis, who are at greatest risk of progression to asthma, appear to be the most logical candidates. Copyright (C) 2004 S. Karger AG, Basel
Clinical, functional, and immunologic effects of sublingual immunotherapy in birch pollinosis: a 3-year randomized controlled study.
No full textRandomized controlled open study of sublingual immunotherapy for respiratory allergy in real-life: clinical efficacy and more
No full textBackground: Some aspects of sublingual immunotherapy (SLIT) still need to be addressed: magnitude of the clinical efficacy, effect on the bronchial hyperreactivity adherence to treatment, preventive effect. We attempted to clarify these points in a randomized open, controlled, two parallel group study in a real-life setting. Methods: Five hundred and eleven patients with allergic rhinitis with or without intermittent asthma were randomized to drugs only or drugs + SLIT (rate 2 : 3) for 3 years. The clinical score (symptoms + drug intake) was measured each year during the allergen exposure. Pulmonary function test, methacholine challenge and skin tests were performed at the beginning and at the end of the study. Adherence to treatment was assessed by measuring the consumed extract. Results: Three hundred and nineteen patients received SLIT and 192 drugs only. Dropouts were 15% in the SLIT group and 12% in the controls. There was a significant improvement of clinical scores in the SLIT group: baseline 147 +/- 3.3, first year 72.9 +/- 1.3, second year 68.3 +/- 1.8, third year 54.7 +/- 2.8 (P < 0.0001 vs baseline). Control group: baseline 138 +/- 2.3, first year 124.1 +/- 3.7, second year 111 +/- 3.3, third year 121 +/- 3.8 (P = NS). Only four patients reported systemic itching. Adherence was >80% in 72% and >60% in 18% of patients. The number of patients with a positive MCh challenge decreased significantly after 3 years only in the SLIT group. New skin sensitizations appeared in 38% of the controls and in 5.9% of the SLIT patients (P = 0.01). Conclusion: Sublingual immunotherapy approximately halved the clinical scores and significantly reduced the bronchial hyperreactivity. Similarly to subcutaneous immunotherapy, SLIT displayed a preventive effect on the onset of new skin sensitizations. The adherence rate was quantitatively satisfactory
Long-lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study.
No full textClinical, functional, and immunologic effects of sublingual immunotherapy in birch pollinosis: A 3-year randomized controlled study
No full textBackground: Sublingual immunotherapy (SLIT) has been proved effective in allergic rhinitis, but there are few studies assessing its effects on inflammation and on the lower airways. Objective: We sought to evaluate at the same time the effects of SLIT on rhinitis symptoms, nasal inflammation, and lower airways function in patients with birch pollinosis. Methods: Adult patients with rhinitis and asthma monosensitized to birch were evaluated during a run-in pollen season and then randomized to receive openly either drugs alone or drugs plus SLIT and reevaluated in the subsequent 4 pollen seasons. Rhinitis symptoms and consumption of bronchodilators were assessed by means of diary card. A nasal smear for eosinophil count was carried out in and out of pollen seasons, and pulmonary function tests with methacholine challenge were performed at each season. Results: Of 79 enrolled patients, 27 dropped out, with a significantly higher rate of dropouts in the control group. There was a decrease in symptoms and bronchodilator use in the SLIT group versus the control group, becoming significant at the second and third pollen seasons, respectively (P < .01 at all times). Nasal eosinophils decreased significantly in the active group, starting from the third pollen season (P < .01). In the SLIT group a significant increase in FEV1, specific airways conductance, and maximal expiratory flow at 25% of forced vital capacity was seen starting from the second year and was associated with an increase in the methacholine threshold dose (P < .01). The differences were significant also at the intragroup comparison over time. Conclusion: SLIT achieved a significant clinical benefit in birch pollinosis, reduced the eosinophil infiltration in nasal mucosa, and significantly improved pulmonary function during the pollen seasons
Randomized controlled open study of sublingual immunotherapy for respiratory allergy in real-life: clinical efficacy and more.
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