title: Specific immunotherapy with standardized latex extract versus placebo in latex-allergic patients.
abstract: BACKGROUND
  Allergy to natural rubber latex proteins continues to be an important medical problem among health care professionals, but also in multioperated children. Clinical manifestations range from urticaria to angioedema, rhinoconjunctivitis, bronchial asthma and anaphylactic shock.
  
  
  METHODS
  The aim of this study was to investigate the efficacy and safety of a 12-month latex-specific immunotherapy in sensitized patients, most often health care workers. Twenty-three patients with latex rhinoconjunctivitis (20 of whom also had asthma) were included in this randomized, double-blind, placebo-controlled trial (11 in the active group, 12 in the placebo group). Treatment efficacy was assessed by means of symptom and medication scores. Conjunctival provocation tests and quantitative skin prick tests were also performed.
  
  
  RESULTS
  The clinical index (derived by combining changes from baseline of six efficacy variables during the treatment period) did not differ significantly between treatment groups. Change from baseline of rhinitis, conjunctivitis, skin symptoms, asthma symptoms, medication score and cutaneous reactivity were not significantly different between the two groups. A nonsignificant difference in conjunctival reactivity was observed in favor of the active group (p = 0.09). Systemic reactions were much higher in the specific immunotherapy than in the placebo group.
  
  
  CONCLUSIONS
  The present study failed to show a significant improvement of symptoms and medication scores, probably because of the low level of symptoms at baseline and the low maintenance dose of therapy, even if allergen-specific conjunctival reactivity decreased in the active group. Moreover, the incidence of systemic reactions was very high in the active group.
authors.affiliation: Sección de Alergología, Hospital Virgen del Camino, Pamplona, Spain.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Tabar
authors.forename: Marta
authors.initials: M
authors.lastname: Anda
authors.forename: Floriano
authors.initials: F
authors.lastname: Bonifazi
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Bilò
authors.forename: Francisque
authors.initials: F
authors.lastname: Leynadier
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuchs
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
authors.forename: Sylvie
authors.initials: S
authors.lastname: Galvain
authors.forename: Claude
authors.initials: C
authors.lastname: André
mesh_terms: D000328:Adult; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007840:Latex / Q000276:immunology; D020315:Latex Hypersensitivity / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012882:Skin Tests
chemical_list: D007074:Immunoglobulin G; D007840:Latex; D007073:Immunoglobulin E