Morales IM, Rodríguez PJ, Gonzáles AJV, Morales MM

Language: Spanish
References: 31
Page: 333-346
PDF size: 187.09 Kb.

ABSTRACT

Background: allergen-specific immunotherapy is the only treatment capable of modifying the natural course of allergic diseases; it has multiple organ and long term effect after stopping its administration and its preventive effects have been tested, both in the prevention of new sensitizations and in the progression of rhinitis to asthma.
Objective: to evaluate the effectiveness of a new subcutaneous immunotherapy schedule with mite extracts in asthmatic adults.
Method: a phase II, open, randomized clinical trial was conducted in 50 patients with diagnosis of mild or moderate bronchial asthma, sensitive to dust mites by Prick test. The study population was constituted by 200 patients with a pathological history of bronchial asthma and aged between 18 and 50 years, who were treated in the Allergology consultation at the University Hospital Manuel Ascunce Domenech, from May 2011 to may 2012. They were given subcutaneous immunotherapy with mite extracts (Dermatophagoides pteronyssinus and Blomia tropicalis) at concentrations of 20 ml/UB 200 UB / UB/ml 2 000 and 20 000 ml/UB/ml in the first group, according to the schedule proposed by BIOCEN, it was reached the maintenance dose in 13 weeks at weekly intervals. The second group received conventional schedule of 16 weeks.
Results: it was found a reduction of clinical symptoms as well as in medication consumption at the end of the treatment in both groups, but significantly in the study group (p=0,020). Skin reactivity to mites significantly decreased in the study group regarding the control group.
Conclusions: a high degree of effectiveness of this new schedule with mites’ extracts was demonstrated, this guarantees a greater adhesion to treatment, which it is far superior to the previous 16-week schedule with a twice-weekly frequency.

REFERENCES

2. Cubas Curvelo M, Chalgub AM. Asma bronquial. En: Cubas Curvelo M, Chalgub AM, editores. El asma y la protección de la capa de ozono. República Dominicana: centeiro; 2009. p. 45-63.

3. Ministerio de Salud Pública: Anuario estadístico. La Habana: Ciencias Médicas; 2011.

4. Fabré Ortiz D, Varona Pérez P, Suárez Medina R. Prevalencia de asma en adolescentes cubanos por diferentes criterios clínicos. Rev Alergia México [Internet]. May-Jun 2005 [citado 15 Ene 2013];52(3):[aprox. 7 p.].Disponible en: http://new.medigraphic.com/cgibin/resumen.cgi?IDREVISTA=84&IDARTICULO=7028&IDPUBLICACION=812

5. Bacigaluppi Federico J. Algunos aspectos de la prevención primaria y secundaria en alergia y asma. Rev Asoc Méd Argent [Internet]. Dic 2008 [citado 15 Ene 2013];121(4):[aprox. 8 p.]. Disponible en: http://www.amamed.org.ar/revistas/2008-4/Prevencion_alergia_asma.pdf

6. Saranz RJ, Lozano A, Cáceres ME, Arnolt RG, Máspero JF, Bozzola CM, et al. Allergen immunotherapy for prevention and treatment of respiratory allergy in childhood. Arch Argent Pediatr. 2010 Jun;108(3):e6. PubMed PMID: 20544144.

7. Passalacqua G, Durham SR. Allergic rhinitis and its impacts on asthma update: allergen immunotherapy. J Allergy Clin Immunol. 2007 Apr;119(4):881-991.

8. Incorvaia C, Frati F. One century of allergen-specific immunotherapy for respiratory allergy. Immunotherapy. 2011 may;3(5):629-35.

9. Jacobsen L, Niggemann B, Dreborg S, Ferdousi HA, Halken S, Høst A, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. 2007 Aug;62(8):943-8.

10. Abramson MJ, Puy RM, Weiner JM. Is allergen immunotherapy effective in asthma? A meta-analysis of randomized controlled trials. Am J Respir Crit Care Med. 1995 Apr;151:969-74.

11. Compalati E, Penagos M, Tarantini F, Passalacqua G, Canonica GW. Specific immunotherapy for respiratory allergy: state of the art according to current meta-analysis. Ann Allergy Asthma Immunol. 2009 Jan;102(1):22-8.

12. Guardia Martínez P, Llamas Huerta ME. Inmunoterapia. Guía práctica para médicos residentes de alergología. Barcelona: MASSON; 2010.

13. Tabar AI, Echechipia S, García BE, Olaguibel JM, Lizaso MT, Gómez B, et al. Double blind comparative study of cluster and conventional immunotherapy schedules with Dermatophagoides pteronyssinus. J Allergy Clin Immunol. 2005 Jul;116(1):109-18.

14. 13.Loza Bisbal Z, Morales Menéndez M, Morales Menéndez M, Machado Del Risco E. Sensibilización cutánea a ácaros en pacientes asmáticos en la Ciudad de Camagüey 2001-2002. Arch Méd Camagüey [Internet]. 2004 [citado 15 Ene 2013];8(1):[aprox. 9 p.].Disponible en: http://www.amc.sld.cu/amc/2004/v8n1/852.htm14. GINA. Global strategy for asthma management and prevention: NHLBI/WHO Report. Bethesda: National Institutes of Health, National Heart, Lung, and Blood Institute; 2007.

15. GINA. Global strategy for asthma management and prevention: NHLBI/WHO Report. Bethesda: National Institutes of Health, National Heart, Lung, and Blood Institute; 2007.

16. Brüggenjürgen B, Reinhold T, Brehler R, Laake E, Wiese G, Machate U, et al. Cost effectiveness of subcutaneous immunotherapy in patients with allergic rhinitis and allergic asthma. Ann Allergy Asthma Immunol. 2008 Sep;101(3):316-24.

17. Yukselen A, Kendirli SG, Yilmaz M, Altintas DU, Karakoc GB. Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: a randomized, placebo-controlled, double-blind, double-dummy study. J Allergy Clin Immunol. 2012 Oct 31;157(3):288-98.

18. Nelson H. Allergen immunotherapy: Where is it now? J Allergy Clin Immunol. 2007 Apr;119(4):769-79.

19. Cox L, Li JT, Nelson H, Lockey R. Allergen immunotherapy: A practice parameter second updated. J Allergy Clin Immunol. 2007 Sep;120(3):25-85.

20. Frati F, Incorvaia C, David M, Scurati S, Seta S, Padua G, et al. Requirements for acquiring a high-quality house dust mite extract fo allergen immunotherapy. Drug Des Devel Ther. 2012 May;6:117-23.

21. Angeles Becerril M. Cambios en la inmunoterapia en México: La nueva Guía de Práctica Clínica. Rev Alergia Méx [Internet]. Ene-Mar 2011 [citado 15 Ene 2013];58:(1):[aprox. 5 p.].Disponible en: http://www.imbiomed.com.mx/1/1/articulos.php?method=showDetail&id_articulo=80611&id_seccion=63&id_ejemplar=7968&id_revista=12

22. Frew AJ. Allergen immunotherapy. J Allergy Clin Immunol. 2010 Feb;125 (2 Supp 2):S306-13.

23. Leatherman B. Injection and sublingual Immunotherapy in the Management of Allergies Affecting the Unified Airway. Otolaryngol Clin N Am. 2008 Apr:41(2):359-374.

24. Ronquillo Díaz M. Primeros ensayos clínicos a doble ciegas, controlados con placebo con las vacunas antialérgicas VALERGEN-DP, VALERGEN-DS y VALERGEN-BT en asmáticos en Cuba. En: Cabrera Cruz N, editor. Premio Anual de la Salud 2008/Dirección Nacional de Ciencia y Técnica del Ministerio de Salud Pública. 33a ed. La Habana: Ciencias Médicas; 2009. p. 13-25.

25. Ross Peña A, Rodríguez Pérez J, Pérez Fabelo M, Sarduy Ramos CM. Eficacia diagnóstica de la prueba cutánea de Prick con extractos alergénicos de ácaros en pacientes asmáticos. Rev Arch Med Camagüey [Internet]. May-Jun 2009 [citado 15 Ene 2013];13(3):[aprox. 6 p.].Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S102502552009000300007&lng=es&nrm=iso&tlng=es

26. Moreno Mora C, Cuesta Herranz J, Fernández-Távora L, Álvarez Cuesta E. Immunotherapy safety: a prospective multi-centre monitoring study of biologically standardized therapeutic vaccines for allergic diseases. Clin Exp Allergy. 2004;34:527-

27. Daher Si, Galvão C, Abe A, Cocco R. Diagnóstico em doenças alérgicas mediadas por IgE. Ver Bras Alergia Imunopatol [Internet]. Jan-Fev 2009 [citado 15 Ene 2013];32(1):[aprox. 9 p.]. Disponible en: http://bases.bireme.br/cgibin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&src=google&base=LILACS&lang=p&nextAction=lnk&exprSearch=525788&indexSearch=ID

28. Larenas Linneman D, Marco F, Enrique E. Inmunoterapia Subcutánea. En: Mendez J, editora. Alergia: Enfermedad Multisistémica. Aspectos básicos y clínicos. México: Panamericana; 2008. p. 45-56.

29. Nelson HS. Multiallergen immunotherapy for allergic rhinitis and asthama. J Allergy Clin Immunol. 2009 Apri;123(4):763-69.

30. Koshkareva YA, Krouse JH. Immunotherapy traditional. Otolaryngol Clin North Am. 2011 Jun;44(3):741-52.

31. Wang HY, Lin XP, Hao CL, Zhang CQ, Sun BQ, Zheng JP, et al. Effect of 1-year specific immunotherapy with standardized house dust mite vaccine on mild to moderate allergic asthmatic patients. Chinese J tuberculosis and respiratory diseases [Internet]. 2006 [citado 15 Ene 2013];29(10):[aprox. 4 p.]. Disponible en: http://www.unboundmedicine.com/medline/citation/17129496/%5BEffect_of_1_year_specific_immunotherapy_with_standardized_house_dust_mite_vaccine_on_mild_to_moderate_allergic_asthmatic_patients%5D_