TOPLINE:

Patients with local allergic rhinitis who received allergen immunotherapy had sustained reductions in nasal-ocular symptoms, more medication-free days, and a substantially lower risk for new asthma than those who did not receive immunotherapy.

METHODOLOGY:

• Researchers conducted a 10-year prospective follow-up study involving 66 patients with moderate-to-severe local allergic rhinitis; of them, 32 patients completed a 3-year course of subcutaneous immunotherapy with extracts of either grass pollen or house dust mite, and 34 matched control individuals declined immunotherapy treatment.
• Primary outcomes were nasal-ocular symptom scores, the use of reliever medication, and medication-free days. Secondary outcomes included the incidence of asthma and new local sensitizations detected by nasal allergen challenge.
• Local allergic rhinitis was defined as a clinical history consistent with allergy to house dust mite or grass pollen in patients with a negative skin prick test, undetectable serum specific immunoglobulin E to aeroallergens, and a positive nasal challenge with Dermatophagoides pteronyssinus or Phleum pratense.

TAKEAWAY:

• A sustained reduction in nasal-ocular symptoms from year 1 onward and significantly more medication-free days from year 3 onward were seen in the intervention group than in the control group (P < .001 for both).
• By years 7-10, 96.9% of patients in the intervention group did not use medications to treat conjunctival symptoms, whereas the control group maintained regular use of medications throughout the study (P < .01).
• Asthma developed in 40.7% of patients in the control group compared with 8.0% of patients in the intervention group. The intervention group had an 83% lower risk of developing asthma than the control group (hazard ratio, 0.17; 95% CI, 0.038-0.765; P = .021).
• New allergic sensitizations were observed in 38.2% of patients in the control group compared with 6.3% of patients in the intervention group (P = .002). The control group had a more than fourfold higher risk of developing new allergic sensitizations than the intervention group (relative risk, 4.08; 95% CI, 1.28-13.00; P = .009).

IN PRACTICE:

“Our findings support the role of AIT [allergen immunotherapy] as a disease-modifying intervention in responder LAR [local allergic rhinitis] patients and provide new evidence for its implementation in the management of this rhinitis phenotype,” the authors of the study wrote. “Early initiation of AIT may reduce the future burden of asthma and more severe allergic phenotypes, ” they added.

SOURCE:

Ibon Eguiluz-Gracia, MD, PhD, and Carmen Rondon, MD, Hospital Regional Universitario de Málaga, Málaga, Spain, were the corresponding authors of the study, which was published online on November 19 in Allergy.

LIMITATIONS:

The study was limited by the lack of randomization in the comparison group and the inclusion of only responders to allergen immunotherapy at year 1. The single-center design focusing on moderate-to-severe local allergic rhinitis driven by grass pollen or house dust mite may have limited generalizability to other allergens, regions, or milder phenotypes.

DISCLOSURES:

The study was supported by Instituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness through various research projects. Open-access funding was provided by Universidad de Málaga/CBUA. Three authors reported receiving honoraria for lecture and advisory activities from various pharmaceutical companies. Various authors reported receiving contracts or grants from various institutions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.