Three-month Effects of Immunotherapy on Clinical Features and Pulmonary Function Tests of Patients with Allergic Rhinitis Concomitant with or without Asthma

Objective: We aimed to evaluate our patient’s treatment responses to three-month immunotherapy for allergic rhinitis with or without asthma, and to investigate the factors affecting treatment Material and Methods: A total of 53 patients receiving subcutaneous immunotherapy for allergic rhinitis with or without asthma were included in the study. All patients were positive for mite skin prick test. Asthma was present as a concomitant disease in 28 (52.8%) patients. Patients with and without asthma were classified in two groups as “Allergic rhinitis + Asthma+” and “Allergic rhinitis+ Asthma-“. The values of pulmonary function tests of all patients, and in rhinitis with asthma patients, the Asthma Control Test scores before and after three months of treatment were recorded. Results: In “Allergic rhinitis + Asthma+” and “Allergic rhinitis + Asthma- “groups, male/female ratio was 7/21 and 10/15, mean age was 33±9 and 32±9 years, respectively. No statistically significant differences were present between the pre-treatment and 3-month-treatment values of pulmonary function test. The difference between the pre-treatment and 3-month treatment asthma control test scores was strongly significant. Conclusion: By using pulmonary function test in allergic rhinitis and asthma control test in asthma, we showed that the effectiveness of allergen specific immunotherapy started in three months, which was earlier when compared to the current literature. When asthma is associated with allergic rhinitis, which is quite common, the control of asthma is also provided with the treatment of allergic rhinitis.

PDF

___

[1] Bousquet J, Khaltaev N, Cruz A.A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy, 2008; 63 Suppl 86: 8-160.

[2] Sakar A, Yorgancioglu A, Dinc G, et al. The prevalence of asthma and allergic symptoms in Manisa, Turkey (A western city from a country bridging Asia and Europe). Asian Pac J Allergy Immunol. 2006; 24(1): 17-25.

[3] Dinmezel S, Ogus C, Erengin H. The prevalence of asthma, allergic rhinitis, and atopy in Antalya, Turkey. Allergy Asthma Proc. 2005; 26(5): 403-9.

[4] Bousquet J, Annesi-Maesano I, Carat F, et al.Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group. Clin Exp Allergy. 2005; 35(6): 728-32.

[5] Antonicelli L, Micucci C, Voltolini S, et al.Allergic rhinitis and asthma comorbidity: ARIA classification of rhinitis does not correlate with the prevalence of asthma. Clin Exp Allergy. 2007; 37(6): 954-60.

[6] Bousquet, J, Vignola AM, Demoly P. Links between rhinitis and asthma. Allergy. 2003; 58(8): 691-706.

[7] Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol. 2011; 127(1):18- 27.

[8] Asamoah F, Kakourou A, Dhami S, et al. Allergen immunotherapy for allergic asthma: a systematic overview of systematic reviews. Clin Transl Allergy. 2017; 7: 25.

[9] Global Initiative for Asthma. Global Strategy for Asthma Management Prevention. 2019; Avaible from: www. ginaasthma.org

[10] Schatz M, Sorkness CA, Li JT, et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol. 2006; 117(3): 549-56.

[11] Nathan RA, Sorkness CA, Kosinski M, et al. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004; 113(1): 59-65.

[12] Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008; 31(1): 143-78.

[13] Yukselen A, Kendirli SG. Role of immunotherapy in the treatment of allergic asthma. World J Clin Cases. 2014; 2(12): 859-65.

[14] Tamaoki J, Isono K, Taira M, et al. Role of regular treatment with inhaled corticosteroid or leukotriene receptor antagonist in mild intermittent asthma. Allergy Asthma Proc. 2008; 29(2): 189-96.

[15] James LK, Durham SR. Update on mechanisms of allergen injection immunotherapy. Clin Exp Allergy. 2008; 38(7):1074-88.

[16] Sozener ZC, Ciftci F, Soyyigit S. et al. Smoking attitudes of the patients with allergic rhinitis: a comparison with asthma and chronic obstructive pulmonary disease. Are there differences when only upper airways are involved? Tuberk Toraks. 2018;66(1):43-51.

[17] Ross RN, Nelson HS, Finegold I. Effectiveness of specific immunotherapy in the treatment of asthma: a metaanalysis of prospective, randomized, double-blind, placebo-controlled studies. Clin Ther. 2000; 22(3):329-41.

[18] Jutel M, Rudert M, Kreimendahl F, et al. Efficacy and tolerability of a house dust mite allergoid in allergic bronchial asthma: a randomized dose-ranging trial. Immunotherapy. 2018; 10(13): 1149-1161.

[19] Valle-Rodriguez F, Lopez-Garcia AI, Rivero-Yeverino D, et al. [The effectiveness and safety of subcutaneous immunotherapy for inhalable allergens in patients with respiratory allergies]. Rev Alerg Mex. 2019; 66(3): 301-307.

[20] Rhyou HI, Nam YH. Efficacy of Allergen Immunotherapy for Allergic Asthma in Real World Practice. Allergy Asthma Immunol Res. 2020; 12(1):99-109.

[21] Abramson MJ, Puy RM, Weiner JM. Injection allergen immunotherapy for asthma. Cochrane Database Syst Rev. 2010; 8: 01186.