title: Clinical evolution of patients with respiratory allergic disease due to sensitisation to Alternaria alternata being treated with subcutaneous immunotherapy.
abstract: BACKGROUND
  Sensitisation to Alternaria is a cause of respiratory disease in Spain, particularly in childhood, but it is also a significant marker of the severity of this disease. Therefore, the use of an aetiological treatment (allergen specific immunotherapy) is essential, and both subjective and objective clinical parameters should be used to follow up this treatment.
  
  
  OBJECTIVE
  This open-label, uncontrolled, observational, prospective study was designed in order to study the evolution of these patients on allergen specific immunotherapy therapy in daily clinical practice and to assess the use of different monitoring tools.
  
  
  METHODS
  A total of 99 patients were included. They were monosensitised to this perennial allergen and treated with subcutaneous allergen specific immunotherapy. After one year of follow-up, these patients were assessed for the presence of symptoms, use of medication, clinical incidents, quality of life and asthma control.
  
  
  RESULTS
  After one year of treatment a significant fall was observed in the use of concomitant medication (β2-agonists: p=0.0278, inhaled corticosteroids: p=0.0007, anti-leukotrienes: p=0.0495), nasal symptoms (p=0.0081), quality of life (PAQLQ, p<0.0001) and asthma control (ACQ, p<0.0001). Twenty-one patients had to attend emergency department due to exacerbation of their allergic disease, and only one of them had to be admitted to hospital.
  
  
  CONCLUSIONS
  respiratory allergic disease due to Alternaria alternata is a disease which is hard to control, and in our daily practice, the use of specific subcutaneous immunotherapy can be of significant benefit in our paediatric patients.
authors.affiliation: Hospital Materno Infantil Gregorio Marañón, Madrid, Spain. lzremon@terra.es
authors.forename: L
authors.initials: L
authors.lastname: Zapatero
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Cañavate
authors.forename: J M
authors.initials: JM
authors.lastname: Lucas
authors.forename: I
authors.initials: I
authors.lastname: Guallar
authors.forename: J
authors.initials: J
authors.lastname: Torres
authors.forename: P
authors.initials: P
authors.lastname: Guardia
authors.forename: F de La
authors.initials: Fde L
authors.lastname: Torre
authors.forename: C
authors.initials: C
authors.lastname: Pedemonte
mesh_terms: D000293:Adolescent; D000528:Alternaria; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D052179:Antigens, Plant / Q000276:immunology / Q000627:therapeutic use; D001249:Asthma; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007279:Injections, Subcutaneous; D008297:Male; D011788:Quality of Life; D012130:Respiratory Hypersensitivity / Q000188:drug therapy* / Q000276:immunology; D013030:Spain
chemical_list: D000893:Anti-Inflammatory Agents; D052179:Antigens, Plant