Allergic rhinitis in remission with house dust mite subcutaneous immunotherapy

Abstract

Background: House dust mite subcutaneous immunotherapy (HDM SCIT) is a therapeutic option for allergic rhinitis (AR) patients who are unable to properly manage symptoms with standard medications.

Objective: This study aimed to determine long-term efficacy and identify predictive factors in the clinical remission of AR patients who completed and discontinued HDM SCIT.

Methods: This study included 240 AR patients, who completed a three-year course of HDM SCIT at two tertiary hospitals and were currently being discontinued. We followed-up the patients to ask about their current symptoms and allergy medication. Clinical remission was defined by patients who no longer required daily intranasal steroid or oral antihistamine. We compared patients in clinical remission to those still taking medication.

Results: The enrolled patients had a median age of 21.0 (11.0-36.0) years at the time they began HDM SCIT. The clinical remission of AR was achieved in 174 (72.5%) patients. Starting HDM SCIT before the age of 15 and not having asthma were identified as significant and independent predictors of remission (aOR 4.44; 95%CI, 1.72-11.50; p-value 0.002, and 2.67, 95%CI 1.00-7.12; p-value 0.049), respectively, as determined by multivariate logistic regression analysis. There were no significant differences in HDM SCIT duration or sensitization patterns between patients in remission and those on medication after discontinuing HDM SCIT for at least one year.

Conclusion: HDM SCIT exhibited persistent long-term efficacy after treatment discontinuation. Starting HDM SCIT before the age of 15 and without asthma comorbidity might be predictors of AR remission with HDM SCIT.