Allergy Asthma Immunol Res.  2020 Jan;12(1):99-109. 10.4168/aair.2020.12.1.99.

Efficacy of Allergen Immunotherapy for Allergic Asthma in Real World Practice

• Rhyou HI
• Nam YH

• KMID: 2462575
• DOI: http://doi.org/10.4168/aair.2020.12.1.99

Abstract

PURPOSE
Allergen immunotherapy (AIT) induces immunological tolerance, and there is increasing evidence of the clinical efficacy of AIT in the treatment of allergic asthma. However, the optimal parameters for asthma control in clinical trials are still unclear. We investigated the efficacy of AIT with respect to changes in the inhaled corticosteroid (ICS) dose in patients with allergic asthma.
METHODS
A total of 117 adults with allergic asthma who had used ICS for more than 1 year in a single tertiary hospital in Korea were included in this retrospective study. We compared the clinical parameters and outcomes between the AIT group (ICS with AIT, n = 48) and the non-AIT group (ICS without AIT, n = 69) by applying an inverse probability of treatment weighting method. The patients in the AIT group had received subcutaneous AIT monthly as a maintenance treatment for more than 1 year. The changes in the ICS dose from baseline were evaluated in the 2 groups for 3 years.
RESULTS
The proportion of responders who discontinued or decreased in the ICS dose with achieving control status of asthma was significantly higher in the AIT group than in the non-AIT group throughout the study period (at 6 months, 52.1% vs. 24.6%; at 1 year, 70.8% vs. 34.7%; at 2 years, 89.5% vs. 35.6%; at 3 years, 96.3% vs. 51.2%). Treatment responses did not differ significantly by type of allergen (single- or multi-allergens or 3 different products) used throughout the study period.
CONCLUSIONS
Irrespective of the type of allergen, long-term maintenance AIT helps to spare ICS dose and achieve better control in patients with allergic asthma in real-world clinical practice.

Keyword

Allergens immunotherapy, desensitization, mite; asthma; corticosteroid; immunomodulation; adult

MeSH Terms

Adult
Asthma*
Desensitization, Immunologic*
Humans
Immunomodulation
Korea
Methods
Retrospective Studies
Tertiary Care Centers
Treatment Outcome

Figure

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  Fig. 1 Study population. The IPTW method was used to balance the subjects between the AIT and the non-AIT groups. IPTW, inverse probability of treatment weighting; AIT, allergen immunotherapy; ICS, inhaled corticosteroid.

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  Fig. 2 Comparison of responders who discontinued or decreased in the ICS dose compared with the baseline in the AIT and non-AIT groups during the 3-year study period. ICS, inhaled corticosteroid; AIT, allergen immunotherapy.

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  Fig. 3 Changes in lung function after 1 year of treatment in the AIT and non-AIT groups. AIT, allergen immunotherapy; FEV1, forced expiratory volume in 1 second; SD, standard deviation.

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  Fig. 4 AEs after 1 year of treatment in the AIT and non-AIT groups. Proportions of patients with AEs (A) and the time to reach the first AE (B) in the 2 groups. AE, acute exacerbation; AIT, allergen immunotherapy; SD, standard deviation.

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  Fig. 5 Comparison of responders between patients in the AIT group treated with HDM alone and those treated with multi-allergens during the 3-year study period. AIT, allergen immunotherapy HDM, house dust mite.

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