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Revista Portuguesa de Imunoalergologia
Print version ISSN 0871-9721
Abstract
PEREIRA, Mariana et al. Control of allergic disease in patients under treatment with subcutaneous allergen immunotherapy. Rev Port Imunoalergologia [online]. 2021, vol.29, n.1, pp.13-25. Epub Mar 31, 2021. ISSN 0871-9721. https://doi.org/10.32932/rpia.2021.03.050.
Background:
Measuring the control of allergic diseases is crucial to assess the outcomes of subcutaneous allergen immunotherapy (SCIT).
Objective:
To describe the control of allergic diseases (asthma, rhinitis, conjunctivitis) in patients treated with SCIT.
Methods:
A descriptive study was carried out of all patients aged >12 years under SCIT between March 2017 and June 2019 at the allergy units of CUF‑Porto and who answered ≥1 evaluation questionnaire prior to SCIT administration (the most recent assessment of each individual was analysed). The questionnaire included CARAT and a visual analogue scale (VAS) for eye symptoms (from 0 - minimum - to 10 cm - maximum). Control of asthma and rhinitis was defined as CARAT total (T) score>24; the control of upper (U) and lower (L) airways was based on CARAT sub‑scores (CARAT U >8 and CARAT L ≥16, respectively).
Results:
We included 209 patients, 96 (46%) female and 62 (30%) aged <18 years. All patients had rhinitis and 32% (n=67) had asthma. 34% of patients were in the first year of SCIT and 40% were in the third or more. CARAT mean score (standard deviation) was 24.6(4.2), with 57% (n=119) controlled patients. 75% (n=50) of those with asthma had controlled lower airways symptoms but only 47% (n=98) had controlled upper airways symptoms. CARAT T and CARAT U scores were not significantly correlated with the duration of SCIT (r=0.082 and - 0.011, respectively), however, CARAT L presented a positive correlation (r=0.203). The median score (interquartile range) for ocular symptoms VAS was 0.3(0.8) cm; 79% of patients scored <1 cm.
Conclusion:
Almost 60% of the patients assessed by CARAT showed control of respiratory allergic disease, but only 47% had controlled rhinitis. Although we observed a higher proportion of controlled patients than published in other settings, further real‑life studies are needed to strengthen evidence of SCIT effectiveness.
Keywords : Allergy; asthma; conjunctivitis; disease control; rhinitis; subcutaneous allergen immunotherapy.