Sublingual immunotherapy in polysensitized patients: effect on quality of life.
BACKGROUND
Quality of life (QOL) is an important issue in allergic rhinitis and has been evaluated in a number of studies that have shown how it is impaired in untreated patients and improved by effective treatment. However, there are no data concerning QOL after sublingual immunotherapy (SLIT) in polysensitized patients.


OBJECTIVE
To evaluate the effect, in real-life clinical practice, of SLIT on QOL in a population of polysensitized patients with allergic rhinitis.


METHODS
We prospectively evaluated 167 consecutively enrolled polysensitized patients with allergic rhinitis. QOL was measured in all cases with the Rhinoconjunctivitis Quality of Life Questionnaire at baseline and after 1 year of SLIT (performed in approximately 70% of cases using single allergen extracts provided by the same manufacturer).


RESULTS
The most frequent causes of sensitization were grass pollen, Parietaria, and house dust mites. The mean number of sensitizations per patient was 3.65. SLIT was performed with 1 extract in 123 patients (73.6%), with 2 extracts in 31 patients (18.6%), and with more than 2 extracts in 13 patients (7.8%). The mean values of all the QOL items improved significantly (P < .01 in all cases), with the following reductions noted: activities, 3.96 to 2.89; sleep, 2.07 to 1.56; general problems, 2.16 to 1.5; practical problems, 3.69 to 2.58; nasal symptoms, 3.57 to 2.50; eye symptoms, 2.92 to 1.83; and emotional aspects, 2.2 to 1.44.


CONCLUSIONS
This study provides evidence that QOL can be improved in polysensitized patients treated with SLIT, and that the use of just 1 or 2 allergen extracts seems to be sufficient and effective in terms of improving QOL.
Ciprandi
G
G
Department of Internal Medicine, University of Genoa, Genoa, Italy. gio.cip@libero.it
Cadario
G
G
Valle
C
C
Ridolo
E
E
Verini
M
M
Di Gioacchino
M
M
Minelli
M
M
Gangemi
S
S
Sillano
V
V
Colangelo
C
C
Pravettoni
V
V
Pellegrino
R
R
Borrelli
P
P
Fiorina
A
A
Carosso
A
A
Gasparini
A
A
Riario-Sforza
G G
GG
Incorvaia
C
C
Puccinelli
P
P
Scurati
S
S
Frati
F
F
D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000627:therapeutic use*; D052179:Antigens, Plant / Q000627:therapeutic use*; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D007114:Immunization; D008297:Male; D032403:Parietaria / Q000276:immunology; D006109:Poaceae / Q000276:immunology; D011058:Pollen / Q000009:adverse effects; D039981:Pyroglyphidae / Q000276:immunology; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*
D039741:Antigens, Dermatophagoides; D052179:Antigens, Plant