ABSTRACT
BACKGROUND: Allergen-specific immunotherapy is an important therapeutic modality for the management of allergic rhinitis and allergic asthma. OBJECTIVE: To assess the effectiveness and safety of allergen-specific subcutaneous immunotherapy in patients with respiratory allergies at the University Hospital of Puebla after twelve months of treatment. METHODS: A longitudinal, sequential, analytic, quasi-experimental, prolective study. The study was carried out for twelve months with patients of both sexes, aged four to sixty-five years, diagnosed with asthma and/or rhinitis, and with sensitization to aeroallergens. The CARAT and Portnoy questionnaires were collected every two months in order to assess the effectiveness and safety respectively. RESULTS: 47 patients were included: 37 (78.7 %) of them were female. The average age was 29.8 years. 76.6 % of them were diagnosed with allergic rhinitis, and 23.4 % of them were diagnosed with both asthma and allergic rhinitis. The comparison of averages of the initial CARAT questionnaire against the final average by means of a student's t-test showed a t-value of -8.86 and a p-value of < 0.05. A total frequency of local adverse reactions of 19 % and systemic adverse reactions of 2.1 % was reported after 6 and 12 months of treatment. CONCLUSIONS: The assessed scheme of immunotherapy, derived from the Mexican clinical practice guidelines of immunotherapy 2011, is effective with a desirable safety profile.
Antecedentes: La inmunoterapia específica con alérgenos es una importante modalidad terapéutica para el manejo de la rinitis y asma alérgica. Objetivo: Evaluar la eficacia y seguridad de la inmunoterapia subcutánea con alérgenos en pacientes con alergia respiratoria del Hospital Universitario de Puebla posterior a 12 meses de tratamiento. Métodos: Estudio longitudinal, secuencial, analítico, cuasiexperimental, prolectivo. Durante 12 meses se incluyeron pacientes con asma o rinitis, sensibilizados a aeroalérgenos, de cuatro a 65 años y de ambos sexos; bimensualmente se recolectaron los cuestionarios CARAT y Portnoy para evaluar la eficacia y seguridad, respectivamente. Resultados: Se incluyeron 47 pacientes, 37 (78.7 %) mujeres. La edad promedio fue de 29.8 años. El 76.6 % tuvo diagnóstico de rinitis alérgica y 23.4 % de asma y rinitis alérgica. Al comparar el promedio del CARAT inicial contra el promedio final mediante prueba de t de Student se obtuvo un valor de 8.86 y p < 0.05. Se reportó una frecuencia total de reacciones adversas locales de 19 % y de reacciones adversas sistémicas de 2.1 % a los seis y 12 meses del tratamiento. Conclusiones: El esquema de inmunoterapia evaluado, derivado de la Guía Mexicana de Práctica Clínica de Inmunoterapia 2011, es eficaz con un conveniente perfil de seguridad.
Subject(s)
Asthma , Respiratory Hypersensitivity , Rhinitis, Allergic , Adult , Allergens/adverse effects , Asthma/therapy , Desensitization, Immunologic , Female , Humans , Male , Rhinitis, Allergic/therapyABSTRACT
BACKGROUND: Specific immunotherapy is a treatment aimed at modifying the course of the allergic disease, with which important immunological and clinical changes are achieved. OBJECTIVE: To assess the effectiveness and safety of subcutaneous immunotherapy in patients diagnosed with respiratory allergies in the University Hospital of Puebla, Mexico. METHODS: A longitudinal, analytic, quasi-experimental study. The study was carried out with patients aged four to sixty-five years, diagnosed with allergic rhinitis or asthma, with sensitization to aeroallergens, in whom immunotherapy was started. For the effectiveness assessment, the Control of Allergic Rhinitis and Asthma Test (CARAT) was used. Safety was assessed through Portnoy's Questionnaire Survey of Adverse Reactions. RESULTS: 59 patients were included: 72.9% were female; 23.7% of them were diagnosed with allergic rhinitis and asthma, and 76.3% were diagnosed with allergic rhinitis. The comparison of averages of the CARAT questionnaire at the beginning of the treatment and after four months of follow up showed a statistically significant positive development. An incidence of adverse local reactions of 9.03% was found; no adverse systemic reactions were reported. CONCLUSIONS: The assessed scheme of subcutaneous immunotherapy got to significantly decrease the asthma symptoms and AR symptoms, with a desirable safety profile.
Antecedentes: La inmunoterapia específica es un tratamiento orientado a modificar el curso de la enfermedad alérgica y con la que se han logrado importantes cambios inmunológicos y clínicos. Objetivo: Evaluar eficacia y seguridad de la inmunoterapia subcutánea en pacientes con diagnóstico de alergia respiratoria en el Hospital Universitario de Puebla, México. Métodos: Estudio longitudinal, analítico, cuasiexperimental. Se incluyeron pacientes de cuatro a 65 años con diagnóstico de asma o rinitis alérgica, con sensibilización a aeroalérgenos, que iniciaron tratamiento con inmunoterapia. Para la valoración de la eficacia se utilizó el cuestionario Control of Allergic Rhinitis and Asthma Test (CARAT). La seguridad se evaluó mediante el cuestionario de reacciones adversas de Portnoy. Resultados: Se incluyeron 59 pacientes, 72.9 % fueron mujeres; 23.7 % con diagnóstico de rinitis alérgica y asma y 76.3 % con diagnóstico de rinitis alérgica. La comparación de promedios del cuestionario CARAT al inicio del tratamiento y a los cuatro meses de seguimiento mostró evolución favorable estadísticamente significativa. Se encontró una incidencia de reacciones adversas locales de 9.03 %; no se reportaron reacciones adversas sistémicas. Conclusiones: El esquema de inmunoterapia subcutánea evaluado logra disminuir significativamente los síntomas del asma y la rinitis alérgica, con un conveniente perfil de seguridad.
