Allergietherapie
(gegen Hausstaubmilben)
Langzeit-Wirkung einer sublingualen,
spezifischen Immuntherapie (SLIT)
- vier Jahre Behandlungsdauer sind optimal.
In der hier vorgestellten Studie zeigte
sich, dass eine über vier Jahre durchgeführte SLIT
auch bei Vorliegen einer Hausstaubmilbenallergie zu empfehlen
ist. Die vierjährige Behandlung wirkt besser als eine
nur über drei Jahre durchgeführte SLIT und nahezu ebenso gut
wie die fünfjährige Therapie. Während es in der Kontrollgruppe
regelmäßig zu neuen Sensibilisierungen kam, wurde dies in allen
drei Therapiegruppen (SLIT über 3, 4 oder sogar 5 Jahre) deutlich
seltener beobachtet. Wurde bei einigen Patienten nach
einigen Jahren eine erneute Immuntherapie notwendig, so stellte
sich der klinische Nutzen sehr viel schneller ein als bei der
ersten Therapie.
Quelle:
MEDLINE Abstract
J Allergy Clin
Immunol.
Autor(en):
Marogna M,
Spadolini I,
Massolo A,
Canonica GW,
Passalacqua G Titel: Long-lasting
effects of sublingual immunotherapy according to its duration:
A 15-year prospective study.
Journal:
J Allergy Clin Immunol.
2010 Oct 7; [Epub ahead of print] Bezug: Pneumology Unit, Cuasso
al Monte, Macchi Hospital Foundation, Varese, Italy.
Abstract:
BACKGROUND:
Data on the long-term effects of sublingual immunotherapy (SLIT)
are sparse, and the optimal duration of treatment is a matter
of debate.
OBJECTIVE:
We sought to prospectively evaluate the long-term effect of
SLIT given for 3, 4, or 5 years and to compare the effect of
those different durations.
METHODS:
In this prospective open controlled study we followed up patients
with respiratory allergy who were monosensitized to mites for
15 years. The subjects were divided in 4 groups receiving drug
therapy alone or SLIT for 3, 4, or 5 years. Clinical scores,
skin sensitizations, methacholine reactivity, and nasal eosinophil
counts were evaluated every year during the winter months. The
clinical effect was considered to persist until clinical scores
remained at less than 50% of the baseline value, and then patients
underwent another course of SLIT.
RESULTS:
Seventy-eight patients were enrolled, and 59 completed the study.
In the 12 control subjects no relevant change in clinical scores
was seen throughout the study. In the patients receiving SLIT
for 3 years, the clinical benefit persisted for 7 years. In
those receiving immunotherapy for 4 or 5 years, the clinical
benefit persisted for 8 years. New sensitizations occurred in
all the control subjects over 15 years and in less than a quarter
of the patients receiving SLIT (21%, 12%, and 11%, respectively).
The second course of vaccination induced a benefit more rapidly
than the first course. The behavior of bronchial hyperreactivity
and nasal eosinophils paralleled the clinical score.
CONCLUSION:
Under the present conditions, it can be suggested that a 4-year
duration of SLIT is the optimal choice because it induces a
long-lasting clinical improvement similar to that seen with
a 5-year course and greater than that of a 3-year vaccination.
Volltext-Artikel:
Swets Information Services
Elsevier Science
PubMed-ID: 20934206 ISSN: 1097-6825 (Electronic) Erstellungsdatum:
11.10.2010