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