fficacy of House Dust Mite Sublingual Immunotherapy in Patients with Atopic Dermatitis: A Randomized, Double-Blind, Placebo-Controlled Tria

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Langer, Sarah Sella ^{[1, 2]} ; Cardili, Renata Nahas ^[2] ; Lima Melo, Janaina Michelle ^[2] ; Leme Ferriani, Mariana Paes ^[2] ; Moreno, Adriana Santos ^[2] ; Dias, Marina Mendonca ^[2] ; Bueno-Filho, Roberto ^[2] ; Candido Pocente, Renata Helena ^[2] ; Roxo-Junior, Persio ^[1] ; Silva, Jorgete ^[1] ; Pereira Valera, Fabiana Cardoso ^{[3, 4]} ; Coelho, Eduardo Barbosa ^[2] ; Santos Galvao, Clovis Eduardo ^[5] ; Carmona, Fabio ^[1] ; Aragon, Davi Casale ^[1] ; Arruda, Luisa Karla ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Pediat, Ribeirao Preto, SP - Brazil

^[2] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Med, Ribeirao Preto, SP - Brazil

^[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Otorhinolaryngol, Ribeirao Preto, SP - Brazil

^[4] Univ Sao Paulo, Ribeirao Preto Med Sch Hosp, Clin Res Unit, Ribeirao Preto, SP - Brazil

^[5] Univ Sao Paulo, Div Clin Immunol & Allergy, Med Sch Hosp, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE; v. 10, n. 2, p. 539+, FEB 2022.
• Citações Web of Science: 1

Resumo

BACKGROUND: Sensitization to house dust mites (HDMs) is frequent in patients with atopic dermatitis. OBJECTIVE: To investigate the efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides pteronyssinus extract in patients with atopic dermatitis sensitized to HDM. METHODS: In this randomized, double-blind, placebo-controlled trial, we enrolled 91 patients 3 years or older, with SCORing Atopic Dermatitis (SCORAD) score greater than or equal to 15 and positive skin test result and/or IgE to D pter-onyssinus. Patients were stratified according to age (<12 and >= 12 years) to receive HDM SLIT or placebo for 18 months. Primary outcome was a greater than or equal to 15-point decrease in SCORAD score. Secondary outcomes were decreases in SCORAD and objective SCORAD, Eczema Area and Severity Index, visual analog scale for symptoms, and pruritus scale scores; Investigator's Global Assessment 0/1; and decrease greater than or equal to 4 points in Dermatology Life Quality Index. Background therapy was maintained. RESULTS: A total of 66 patients completed the study (35 HDM SLIT, 31 placebo). After 18 months, 74.2% and 58% of patients in the HDM SLIT group and the placebo group, respectively, showed greater than or equal to 15-point decrease in SCORAD score (relative risk, 1.28; 95% CI, 0.89-1.83). Significant SCORAD score decreases from baseline of 55.6% and 34.5% in HDM SLIT and placebo groups (mean difference, 20.4; 95% CI, 3.89-37.3), significant objective SCORAD score decreases of 56.8% and 34.9% in HDM SLIT and placebo groups (mean difference, 21.3; 95% CI, 0.66-41.81), and more patients with Investigator's Global Assessment 0/1 in the HDM SLIT group as compared with the placebo group (14 of 35 vs 5 of 31; relative risk, 2.63; 95% CI, 1.09-6.39) were observed at 18 months. CONCLUSIONS: Our results suggest that HDM SLIT may be effective in HDM-sensitized patients as an add-on treatment for atopic dermatitis. (C) 2021 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma \& Immunology. (AU)

• Processo FAPESP: 19/26678-0 - Dermatite atópica em pacientes brasileiros: aspectos genéticos, resposta imune e imunoterapia em pacientes alérgicos a ácaro
• Beneficiário: Luisa Karla de Paula Arruda
• Modalidade de apoio: Auxílio à Pesquisa - Regular