The Effectiveness of Allergen Immunotherapy in Adult Patients with Atopic Dermatitis Allergic to House Dust Mites

被引:5
作者
Bogacz-Piaseczynska, Agnieszka [1 ]
Bozek, Andrzej [1 ]
机构
[1] Med Univ Silesiaia Katowice, Clin Dept Internal Dis Dermatol & Allergol Zabrze, Sklodowskiej 10, PL-41800 Zabrze, Poland
来源
MEDICINA-LITHUANIA | 2023年 / 59卷 / 01期
关键词
atopic dermatitis; allergen immunotherapy; IgE; house dust mites; GUIDELINES; EFFICACY; CHILDREN; ECZEMA;
D O I
10.3390/medicina59010015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and objectives: Allergen immunotherapy (AIT) is not a first-line therapy in atopic dermatitis (AD) and its effectiveness has been criticised. Objectives: The efficacy and safety of AIT in adult patients with AD and monosensitisation to house dust mites (HDMs) were investigated. Materials and Methods: A total of 37 patients were included in this double-blind, placebo-controlled study. Patients were eligible if they were diagnosed with AD; had moderate-to-severe AD according to the Eczema Area and Severity Index (EASI) with at least 7.1 points, the % BSA (body surface area) scale with at least 16 points, and the IsGA (investigator global assessment) scale with 3 points; had positive skin prick tests (SPTs); and were positive for the specific immunoglobulin E (sIgE) response to D. pteronyssinus and D. farinae extracts, as well as Der p 1 and Der f1. The patients received Purethal mites (20,000 AUeq/mL, HAL Allergy, Leiden, The Netherlands) with the extract allergens D. pteronyssinus and D. farinae (50/50%) or a placebo for 12 months. The primary outcomes included changes in EASI, % BSA, and IsGA due to SCIT between the start and after 12 months of therapy. Results: In the study group, significant improvement was observed in terms of the EASI score from 43 +/- 8.2 to 21 +/- 5.9 points, % BSA from 72 +/- 18 to 28 +/- 11 points, and IsGA from 4.5 +/- 0.5 to 1.5 +/- 0.5 points in comparison with the placebo after 1 year of AIT. Additionally, the proportion of patients who achieved success in the IsGA (IsGA < 2) was significantly better in comparison to the placebo with 13/20 (65%) vs. 4/14 (29%), respectively (p < 0.05). Conclusions: HDM-AIT effectively improved atopic dermatitis in patients that strictly qualified for desensitisation with a confirmed monovalent mite allergy.
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页数:11
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