title: High-dose sublingual immunotherapy in patients with uncontrolled allergic rhinitis sensitized to pollen: a real-life clinical study.
abstract: BACKGROUND
  High-dose pollen sublingual immunotherapy (SLIT) is indicated in patients with moderate to severe allergic rhinitis (AR), especially those who are unable to control their disease with pharmacotherapy. We explore the use of high-dose SLIT in patients with severe AR and sensitized to pollen, in real-life clinical practice. We also analyzed the effect on asthma.
  
  
  METHODS
  This was a prospective observational study conducted at the Allergy outpatient clinic at Hotel Dieu de France Hospital (HDF), Beirut, Lebanon. The cohort, composed of 118 patients between 7 and 55 years old, was regularly evaluated at inclusion, at 12 months, and at 36 months. Fifty-five percent of AR patients had associated controlled asthma. Patients received a standardized pollen extract (Staloral 300IR). The pollen combination was 1 to 3 pollens, the most commonly used were Parietaria judaica, Cupressaceae, 5 grasses, and Oleaceae. In a previous study, those were the main allergenic pollens correlated to AR in the same population. Global assessment of the effect of SLIT was measured using a rhinitis total symptom score (RTSS), a rhinitis medication consumption score (RMCS), a global asthma score (ASS), and an asthma medication consumption score (AMCS).
  
  
  RESULTS
  Using a t test we found that the average scores at inclusion, 12 months, and 36 months, respectively, were as follows: RTSS: 31.32, 16.39 (p < 0.041), and 13.35 (p < 0.041); RMCS: 6.96, 1.96 (p < 0.0162), and 1.61 (p < 0.0162); ASS: 4.62, 1.96 (p < 0.0005), and 1.33 (p < 0.0005); and AMCS: 2.35, 0.78 (p < 0.0005), and 0.7 (p < 0.0005).
  
  
  CONCLUSIONS
  Our study showed favorable results of SLIT to aeroallergens in patients with uncontrolled AR. The effect is also applicable to the subgroup of patients suffering from concomitant, controlled asthma.
authors.affiliation: Allergy and Internal Medicine Department, Saint Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Medicine, Pulmonary Division, University of Alberta Hospital, Edmonton, Alberta, Canada.
authors.forename: Carla
authors.initials: C
authors.lastname: Irani
authors.forename: Roula Abi
authors.initials: RA
authors.lastname: Saleh
authors.forename: Mouin
authors.initials: M
authors.lastname: Jammal
authors.forename: Fady
authors.initials: F
authors.lastname: Haddad
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000009:adverse effects*; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000009:adverse effects*; D011446:Prospective Studies; D065631:Rhinitis, Allergic / Q000209:etiology / Q000628:therapy*; D063729:Sublingual Immunotherapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000485:Allergens
keywords: allergic rhinitis; asthma; medication score; sublingual immunotherapy; symptoms score