Efficacy of Sublingual Immunotherapy after Early Adverse Events in Allergic Rhinitis

Abstract

Objectives:

Sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment of allergic rhinitis (AR). However, some patients experience early adverse events (EAE) during SLIT. This study aimed to investigate the predisposing conditions of EAE and the influence of EAE on treatment outcomes in the house dust mite (HDM) SLIT for AR.

Methods:

As a retrospective cohort study, 226 patients diagnosed with AR and sensitized to HDM started HDM-SLIT in 2010. The symptomatic improvement was measured by a total nasal symptom score (TNSS) before and 6 months after SLIT. EAE were divided into 3 categories, local and systemic EAE and aggravation of nasal symptoms. The TNSS in the 3 groups of EAE were compared. The medical records and diaries of 125 patients were reviewed.

Results:

TNSS decreased from 9.7 to 3.9 six months after SLIT. There were 28 patients (22.4%) who experienced EAE. TNSS was improved in both non-EAE and EAE groups 6 months after SLIT, and there was no difference in the 6-month changes of TNSS between the non-EAE and EAE groups. Significant improvement of TNSS was found in local EAE or early aggravation of the symptoms. The rescue medication score in the group of local EAE stayed relatively low both 1 month and 6 months after SLIT.

Conclusions:

Even though HDM-SLIT sometimes caused EAE, it did not affect SLIT. The cumbersome local EAE in SLIT was self-limited and neither gave an adverse influence to the symptomatic improvement nor elevated the frequency of the rescue medication.