Clinical and patient based evaluation of immunotherapy for grass pollen and mite allergy.
BACKGROUND
Treatment of allergic disease can be done by pharmacological intervention by allergen avoidance--in the following called standard care (SC), or by specific treatment with allergy vaccination; Specific Immunotherapy (SIT). The aim of this study were to evaluate the effects of subcutaneously administrated SIT compared to SC by objective (clinical/medical records) and subjective parameters (patient's opinion) in a before/after SIT study.


METHODS
The study included retrospectively all grass- and mite allergic 16-60 year old patients (N = 253) who had started SIT for grass pollen or mite allergy during the period 1.1.1996-1.1.2002 at The Allergy Unit, Aarhus University Hospital, or at a specialist practice in Aarhus. Relevant data were collected before/after treatment from medical records and from a specific designed questionnaire. The following indicators for effect were applied: Success of immunotherapy expressed as completion of up dosing phase, change in symptoms, a comparison of overall rhinoconjunctivitis symptoms, number of symptom free days per year, effect of pharmaceuticals, change in physical and psychological wellbeing and number of lost days from work/education and leisure activities.


RESULTS
Compliance for completed up dosing for SIT was 94 % (95 % CI 90-97). The questionnaire revealed that after SIT there were a significant reduction in degree of symptoms, 84 % (95 % CI 79-89) of the respondents achieved a reduction in over all rhinoconjunctivitis score, there were an increase in symptom free days per year, a decrease in days off/incapacity from work/education and leisure activities, an improved effect of the pharmaceuticals used for allergic symptoms and an improvement in physical and psychological wellbeing. The study also showed that SIT was more effective treating rhinoconjunctivitis symptoms than lung symptoms.


CONCLUSIONS
The study revealed great advantages of SIT compared to SC and a high compliance for SIT during the up dosing period.
Dam Petersen
K
K
Health Economics, Institute of Public Health, University of Southern Denmark-Odense University, Denmark. kdpetersen@health.sdu.dk
Gyrd-Hansen
D
D
Kjaergaard
S
S
Dahl
R
R
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D001249:Asthma / Q000209:etiology / Q000628:therapy; D003233:Conjunctivitis, Allergic / Q000209:etiology / Q000628:therapy*; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008925:Mites / Q000276:immunology*; D006109:Poaceae; D011058:Pollen / Q000009:adverse effects* / Q000276:immunology; D012130:Respiratory Hypersensitivity / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000209:etiology / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000485:Allergens