Predicting allergen immunotherapy efficacy based on early maintenance phase response in routine clinical practice

作者：Rundong Qin, Wanyi Fu, Renbin Huang, Mo Xian, Yubiao Guo, Li He, Xu Shi, Jing Li · 发表于：World Allergy Organization Journal · 年份：2024 · DOI：10.1016/j.waojou.2024.100986 · 被引用次数：7 · 研究领域：Allergic Rhinitis and Sensitization、Asthma and respiratory diseases、Food Allergy and Anaphylaxis Research

Background While allergen-specific immunotherapy (AIT) is acknowledged as an effective treatment, its efficacy varies, and consensus on predictive indicators for AIT responders remains elusive. Objective This study aimed to identify alternative parameters for predicting AIT responders based on clinical data collected in daily practice. Method We conducted a retrospective analysis of patients with house-dust-mite-driven asthma and/or rhinitis who completed 3 years of subcutaneous AIT (3y-AIT). We assessed the efficacy of AIT using the estimated daily symptom and medication score (edSMS) during different treatment periods, including up-dosing, maintenance I, II, and III phases. These scores were derived from detailed records of symptoms and medication use for AIT injections. A responder was defined as an individual with a reduction in edSMS of at least 30% from up-dosing to maintenance III phase (ΔedSMS U-M3 ). Results A cohort of 133 patients was analyzed, revealing a significant overall improvement in the disease condition after 3y-AIT. Responders demonstrated lower rates of polysensitization, daily tobacco smoke exposure, and milder pretreatment disease severity compared to non-responders (p = 0.003, p = 0.001, and p = 0.019, respectively). We observed 8 clinical response patterns among included subjects, but only a small group of patients (16/133, 12.03%) demonstrated consistent improvement throughout the 3y-AIT. Serum total immunoglobulin E (tIgE), specific immunoglobulin ...