Efficacy of house dust mite sublingual immunotherapy in patients with atopic dermatitis: a randomized, double-blind, placebo-controlled trial
| Autor: | Jorgete Maria e Silva, Janaina Michelle Lima Melo, Roberto Bueno-Filho, Clóvis Eduardo Santos Galvão, Adriana S. Moreno, Pérsio Roxo-Junior, Mariana Paes Leme Ferriani, Davi Casale Aragon, Eduardo Barbosa Coelho, Sarah Sella Langer, Fabiana Cardoso Pereira Valera, Renata Helena Candido Pocente, Renata Nahas Cardili, Fabio Carmona, Luisa Karla de Paula Arruda, Marina Mendonça Dias |
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| Rok vydání: | 2022 |
| Předmět: |
House dust mite
medicine.medical_specialty medicine.diagnostic_test biology business.industry Visual analogue scale Placebo-controlled study ESTUDOS RANDOMIZADOS Atopic dermatitis Dermatology Life Quality Index medicine.disease Placebo biology.organism_classification Eczema Area and Severity Index Gastroenterology Internal medicine medicine Immunology and Allergy SCORAD business |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| Popis: | Background Sensitization to house dust mites (HDM) is frequent in patients with atopic dermatitis (AD). Objective To investigate the efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides pteronyssinus(Dpt) extract in patients with AD sensitized to HDM. Methods In this randomized, double-blind, placebo-controlled trial, we enrolled 91 patients aged ≥3 years, with SCORing Atopic Dermatitis (SCORAD) ≥15 and positive skin test and/or IgE to Dpt. Patients were stratified according to age ( > 15-point decrease in SCORAD. Secondary outcomes were decreases in SCORAD and objective SCORAD (O-SCORAD), Eczema Area and Severity Index (EASI), visual analog scale (VAS) for symptoms, pruritus scale; Investigator’s Global Assessment (IGA) 0/1; and decrease ≥4 points in Dermatology Life Quality Index (DLQI). Background therapy was maintained. Results A total of 66 patients completed the study (35 HDM SLIT, 31 placebo). After 18 months, 74.2% and 58% patients in HDM SLIT and placebo groups, respectively, showed > 15-point decrease in SCORAD (relative risk[RR]1.28, 95% confidence interval[CI] 0.89-1.83). Significant SCORAD decreases from baseline of 55.6% and 34.5% in HDM SLIT and placebo groups (mean difference 20.4;95%CI 3.89-37.3); significant O-SCORAD decreases of 56.8% and 34.9% in HDM SLIT and placebo groups (mean difference 21.3;95%CI 0.66-41.81); and more patients with IGA 0/1 in HDM SLIT group as compared to placebo group (14/35 vs 5/31;RR 2.63, 95%CI 1.09-6.39), were observed at 18 months. Conclusion Our results suggest that HDM SLIT may be effective in HDM sensitized patients as an add-on treatment for AD. |
| Databáze: | OpenAIRE |
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