Retrospective Analysis on the Effects of House Dust Mite Specific Immunotherapy for More Than 3 Years in Atopic Dermatitis
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Purpose: In extrinsic atopic dermatitis (AD), house dust mites (HDM) play a role in eliciting or aggravating allergic lesions. Thenature of skin inflammation in AD has raised a growing interest in allergen-specific immunotherapy (SIT). Thus, we assessedclinical improvement and laboratory parameters for evaluation of the benefit of long-term SIT. Materials and Methods: A total of 217 AD patients who were treated with SIT for at least 3 years were retrospectively assessed, byusing their investigator global assessment, pruritus scores, loss of sleep (LOS), total serum IgE, and eosinophil counts collected. Patients were additionally classified into subgroups according to age, initial AD severity and mono- or multi-sensitization to includedifferent individual factors in the evaluation of SIT efficacy. Lastly, we compared laboratory data of good responders to SITwith that of poor responders to SIT. Results: Improvement after SIT therapy was observed in 192 out of 217 patients (88.4%). Among these patients, 138 (63.5%)achieved excellent, near-complete or complete clinical remission. Significant reduction of pruritus, LOS, and the mean value oftotal serum IgE were observed (p<0.01). Better outcome was found in patients younger than 12 years of age (p=0.024). Patientswith moderate to severe AD showed better treatment outcomes (p=0.036). Patients sensitized only to HDM had the better responseto treatment, but SIT was also effective in multi-sensitized groups (p=1.051). No significant differences in baseline laboratoryresults were observed between good and poor responders (p>0.05). Conclusion: We emphasize the usefulness of long-term HDM SIT as a disease-modifying therapy for AD.
Abstract
Purpose: In extrinsic atopic dermatitis (AD), house dust mites (HDM) play a role in eliciting or aggravating allergic lesions. Thenature of skin inflammation in AD has raised a growing interest in allergen-specific immunotherapy (SIT). Thus, we assessedclinical improvement and laboratory parameters for evaluation of the benefit of long-term SIT. Materials and Methods: A total of 217 AD patients who were treated with SIT for at least 3 years were retrospectively assessed, byusing their investigator global assessment, pruritus scores, loss of sleep (LOS), total serum IgE, and eosinophil counts collected. Patients were additionally classified into subgroups according to age, initial AD severity and mono- or multi-sensitization to includedifferent individual factors in the evaluation of SIT efficacy. Lastly, we compared laboratory data of good responders to SITwith that of poor responders to SIT. Results: Improvement after SIT therapy was observed in 192 out of 217 patients (88.4%). Among these patients, 138 (63.5%)achieved excellent, near-complete or complete clinical remission. Significant reduction of pruritus, LOS, and the mean value oftotal serum IgE were observed (p<0.01). Better outcome was found in patients younger than 12 years of age (p=0.024). Patientswith moderate to severe AD showed better treatment outcomes (p=0.036). Patients sensitized only to HDM had the better responseto treatment, but SIT was also effective in multi-sensitized groups (p=1.051). No significant differences in baseline laboratoryresults were observed between good and poor responders (p>0.05). Conclusion: We emphasize the usefulness of long-term HDM SIT as a disease-modifying therapy for AD.
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