Specific immunotherapy has long‐term preventive effect of seasonal and perennial asthma: 10‐year follow‐up on the PAT study

Allergy: European Journal of Allergy and Clinical Immunology - Tập 62 Số 8 - Trang 943-948 - 2007
Lars Jacobsen1, B. Niggemann2, Sten Dreborg3, Hosne Ara Ferdousi4, Susanne Halken5, Arne Høst6, A. Koivikko7, L. A. Norberg6, Erkka Valovirta7, Ulrich Wahn2, C. Möller8
1ALK-Abelló, Hørsholm, Denmark
2Department of Pediatric Pneumology and Immunology, Charité, Berlin, Germany
3Department of Pediatrics, University Hospital of Oslo, Oslo, Norway
4Department of Pediatrics, University of Linköping, Linköping, Sweden.
5Department of Pediatrics, Hospital of Sønderborg, Sønderborg, Denmark
6Department of Pediatrics, University Hospital of Odense, Odense, Denmark
7Turku Allergy Centre, Turku, Finland
8Department of Pediatrics, Umeå University, Umeå, Sweden

Tóm tắt

Background:  3‐year subcutaneous specific immunotherapy (SIT) in children with seasonal allergic rhinoconjunctivitis reduced the risk of developing asthma during treatment and 2 years after discontinuation of SIT (5‐year follow‐up) indicating long‐term preventive effect of SIT.Objective:  We evaluated the long‐term clinical effect and the preventive effect of developing asthma 7‐years after termination of SIT.Methods:  One hundred and forty‐seven subjects, aged 16–25 years with grass and/or birch pollen allergy was investigated 10 years after initiation of a 3‐year course of SIT with standardized allergen extracts of grass and/or birch or no SIT respectively. Conjunctival provocations were performed outside the season and methacholine bronchial provocations were performed during the season and winter. Asthma was assessed by clinical evaluation.Results:  The significant improvements in rhinoconjunctivitis and conjunctival sensitivity persisted at the 10‐year follow‐up. Significantly less actively treated subjects had developed asthma at 10‐year follow‐up as evaluated by clinical symptoms [odds ratio 2.5 (1.1–5.9)]. Patients who developed asthma among controls were 24/53 and in the SIT group 16/64. The longitudinal treatment effect when adjusted for bronchial hyper‐responsiveness and asthma status at baseline including all observations at 3, 5 and 10 years follow‐up (children with or without asthma at baseline, n = 189; 511 observations) was statistically significant (P = 0.0075). The odds ratio for no‐asthma was 4.6 95% CI (1.5–13.7) in favor of SIT.Conclusion:  A 3‐year course of SIT with standardized allergen extracts has shown long‐term clinical effects and the potential of preventing development of asthma in children with allergic rhinoconjunctivitis up to 7 years after treatment.Clinical implication:  Specific immunotherapy has long‐term clinical effects and the potential of preventing development of asthma in children with allergic rhino conjunctivitis up to 7 years after treatment termination.

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Thông tin xuất bản

Allergy: European Journal of Allergy and Clinical Immunology

Tập 62 Số 8

943-948

Thông tin tác giả