Source: Annual Congress 2002 - Asthma and COPD: pharmacology
Disease area: Airway diseases

Abstract

A double-blind, placebo controlled trial of specific immunotherapy (IT) was performed in 95 mild to moderate asthmatic subjects allergic to house dust mite (HDM). Optimal medical treatment and standard measures of HDM avoidance were given for one run-in year. Then, the subjects were randomly assigned to receive subcutaneous injections of either a 1:1 mixture of Dermatophagoides pteronissinus and farinae extracts or a placebo for three years. Medications were adjusted every 3 months on the basis of peak expiratory flow (PEF) measurements and symptoms.
Forty-one subjects in active IT and 31 in placebo completed the study. Skin reactivity to 4, 20, and 100 BU/ml of HDM extracts determined by prick test was reduced only in active treatment group at the end of 3-yr IT (p<0.001). Asthma symptoms and medication scores declined in both groups over the study period. No changes in FEV1 and bronchial hyperresponsiveness, measured by methacholine inhalation test, were observed in the two groups. A time-dependent improvement of morning peak expiratory flow (PEF) was detected in patients on active IT (p=0.0005), but not in the placebo-treated group.
In conclusion, immunotherapy with injection of HDM extract for three years, combined to measures of HDM avoidance and drug treatment, induces attenuation of skin reactivity to the allergen and improvement of morning PEF. The results suggest that reduction of response to allergen provides little additional clinical benefit in allergic asthmatics who were receiving appropriate medical care.
Supported by Regione Veneto, ALK-Abellò, MIUR, ARCA.

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Citations should be made in the following way:
P. Maestrelli, L. Zanolla, P. Puccinelli, M. Pozzan, L. M. Fabbri (Verona, Milan, Italy). Effects of 3-yr immunotherapy with standardised extracts of house dust mite in allergic asthmatic subjects receiving appropriate drug treatment. Eur Respir J 2002; 20: Suppl. 38, 738

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