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Specific immunotherapy in long-term asthma prevention
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Allergic asthma is one of the common and very serious consequences of allergic rhinoconjunctivits (`hay fever`). Specific immunotherapy is recommended to reduce the risk of developing asthma. This brandnew study shows that a specific immunotherapy reduces the risk of asthma even years after discontinuation!
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A 3-year subcutaneous specific immunotherapy (SIT) in children with seasonal allergic rhinoconjunctivitis reduced the risk of developing asthma during treatment and 2 years after discontinuation of SIT (5-year follow-up) indicating long-term preventive effect of SIT.
Now, the long-term clinical effect and the preventive effect of developing asthma 7-years after termination of SIT should be evaluated.
One hundred and forty-seven subjects, aged 16–25 years with grass and/or birch pollen allergy was investigated 10 years after initiation of a 3-year course of SIT with standardized allergen extracts of grass and/or birch or no SIT respectively.
Conjunctival provocations were performed outside the season and methacholine bronchial provocations were performed during the season and winter. Asthma was assessed by clinical evaluation.
Results: The significant improvements in rhinoconjunctivitis and conjunctival sensitivity persisted at the 10-year follow-up.
Significantly less actively treated subjects had developed asthma at 10-year follow-up as evaluated by clinical symptoms [odds ratio 2.5 (1.1–5.9)].
Patients who developed asthma among controls were 24/53 and in the SIT group 16/64.
The longitudinal treatment effect when adjusted for bronchial hyper-responsiveness and asthma status at baseline including all observations at 3, 5 and 10 years follow-up (children with or without asthma at baseline, n = 189; 511 observations) was statistically significant (P = 0.0075). The odds ratio for no-asthma was 4.6 95% CI (1.5–13.7) in favor of SIT.
Conclusion: A 3-year course of SIT with standardized allergen extracts has shown long-term clinical effects and the potential of preventing development of asthma in children with allergic rhinoconjunctivitis up to 7 years after treatment.
Clinical implication: Specific immunotherapy has long-term clinical effects and the potential of preventing development of asthma in children with allergic rhino conjunctivitis up to 7 years after treatment termination.
Source: L. Jacobsen, B. Niggemann, S. Dreborg, H. A. Ferdousi, S. Halken, A. Høst, A. Koivikko, L. A. Norberg, E. Valovirta, U. Wahn, C. Möller, (The PAT investigator group) (2007): Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. In: Allergy 62 (8), 943–948.
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