Abstract

SANTOS, Amélia Spínola; FERREIRA, Manuel Branco  and  BARBOSA, Manuel Pereira. Specific immunotherapy and asthma control. Rev Port Imunoalergologia [online]. 2012, vol.20, n.2, pp.109-120. ISSN 0871-9721.

Background: Specific immunotherapy (SIT) is associated with immunological modulation, therefore being able to induce, in allergic asthmatic patients, progressive and sustained clinical improvements. Objective: Assess SIT efficacy in maintaining asthma control. Material and methods: In March/2007 a clinical questionnaire and the Asthma Control Test (ACT) were fulfilled by 252 asthmatic patients, during their hospital appointment and in the presence of their allergologist. In March/2010 we sent by mail, to the same patients, the ACT and one other clinical questionnaire. We compared their answers and ACT scores between 2007 and 2010 and between patients that had received SIT and those who hadn’t. Results: We obtained 96 answers, 29 from asthmatics who had received at least 4 years of SIT and 67 from non SIT -treated asthmatics. Both groups of patients presented in 2010 a mean ACT score slightly lower than in 2007 (22.2 vs. 22.7 in SIT-treated and 20.9 vs. 21.2 in non SIT -treated) but without significant differences. However, in 2010 only 30% of SIT-treated patients were using daily inhaled steroids versus 62% of the non SIT-treated patients (p<0.01). Conversely, systemic steroids were used in 17% of the non SIT -treated patients and in 0% of the SIT -treated (p=0.03). SIT-treated patients had also lesser recourse to Emergency Room (1.5 vs. 3.2; p=0.02) and a lesser prevalence of self -reported diabetes (0 vs. 10%; p=0.03). Although asthma control was generally good, we highlight the fact that around 30% of patients in both groups state some limitations to their daily lives due to their asthma. Conclusions: Most patients under specialized allergologic follow -up maintain, in 3 years, good levels of asthma control. In the SIT -treated patients we observed additional improvements in other parameters, reflecting relevant immune modulating actions of SIT.

Keywords : ACT questionnaire; asthma; control; specific immunotherapy.

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