A large scale multicentre randomized, placebo-controlled subcutaneous house dust mite allergen immunotherapy (HDM SCIT) in allergic rhinitis: MITAR Study.

Autor:	Suratannon N; Center of Excellence for Allergy and Clinical Immunology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, the King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand., Limsuwan T; Division of Allergy Immunology & Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Tantilipikorn P; Center of Research Excellence in Allergy and Immunology, Department of Otorhinolaryngology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand., Chatchatee P; HAUS IAQ Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand., Saengapaswiriya A; Division of Allergy and Immunology, Department of Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand., Boonpiyathad T; Division of Allergy and Immunology, Department of Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand., Thongngarm T; Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Roongpuvapaht B; Department of Otolaryngology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Chantaphakul H; Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University; and the King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Kulalert P; Division of Allergy and Immunology, Thammasat University Hospital, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand., Thanaviratananich S; Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Thailand., Sangsupawanich P; Division of Allergy and Clinical Immunology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Bangkok, Thailand., Fooanant S; Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand., Manuyakorn W; Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Chusakul S; Otolaryngology Department, Faculty of Medicine, Chulalongkorn University; and the King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Piboonpochanun O; Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Apornpong T; Division of Statistic, HIVNAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand., Wongpiyabovorn J; Division of Immunology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand., Ruxrungtham K; Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University; and the King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.; Chula Vaccine Research Center (Chula VRC); and School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Jazyk:	angličtina
Zdroj:	Asian Pacific journal of allergy and immunology [Asian Pac J Allergy Immunol] 2024 Sep; Vol. 42 (3), pp. 233-245.
DOI:	10.12932/AP-221123-1735
Abstrakt:	Background: Previous house dust mite subcutaneous immunotherapy (HDM SCIT) placebo-controlled trials have small sample sizes and lack a consensus on baseline treatment. Objective: To determine the efficacy of HDM SCIT in moderate-to-severe allergic rhinitis (AR) patients treated with an intranasal corticosteroid at baseline. Methods: We conducted a randomized, placebo-controlled trial comparing HDM SCIT against placebo in Dermatophagoides pteronyssinus (Der p) sensitized. All patients received standard of care according to Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, including an intranasal steroid (INCS) at baseline. The primary endpoint was the comparison of a composite score, combining the total nasal symptom score and medication score, assessed at the twelfth month post-treatment. Results: Of the 144 subjects, 108 received HDM-SCIT and 36 received a placebo. The median age was 30 years (range 11-61), with 60% being female. The mean Der p wheal diameter was 9.4 mm (SD 4.4). After one year of treatment, the composite score median (IQR) in the HDM SCIT group and the placebo group was 0.75 (0.50-1.13) and 0.63 (0.50-1.25), respectively (p > 0.05). Both groups exhibited a significant mean change in the composite score from baseline (p < 0.001), but there was no significant difference between the groups. The median (IQR) serum Der p-specific immunoglobulin G4 level significantly increased only in the HDM SCIT arm (p ≤ 0.001). Conclusion: One-year HDM SCIT significantly reduced both symptoms and medication use in HDM-allergic rhinitis patients. However, the changes were not significantly different from those in the placebo group, who also received an INCS at baseline. A longer-term study is warranted to assess disease modification factors.
Databáze:	MEDLINE
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