Efficacy And Safety Study Of Subcutaneous Specific Immunotherapy In Allergic Rhinitis

Objective:To evaluate the medium-and long-term efficacy of standardized mite allergen subcutaneous immunotherapy(SCIT)in patients with allergic rhinitis and to evaluate its safety.Methods:Patients diagnosed with allergic rhinitis at Yangzhou University Affiliated Hosptial between 2019 and 2022 were retrospectively analysed for double mite(house dust mite and dust mite)allergy confirmed by skin allergen prick test.All patients were treated with SCIT for at least 2 years and followed up at the time of treatment.Patients were divided into two groups according to the presence or absence of systemic reactions(SRs)and non-systemic reactions(nSRs),which were recorded as the SRs and nSRs groups respectively.Clinical data were collected to evaluate patients’ VAS score,rhinoconjunctivitis symptom score DSS,medication score TMS,combined medication symptom score CSMS,modified nasal endoscopy score MLK and rhinitis quality of life assessment RQLQ at pre-treatment baseline,six months and 2 years of treatment,with each assessment time point being the last 1 week.The efficacy of SCIT in treating patients with mite allergic rhinitis was assessed by comparing all patients’ own follow-up indicators before and after treatment by paired rank sum test;the indicators of gender,age,history of smoking or passive smoking,severity of disease,whether combined with multiple allergens,drug allergy history and family allergy history of patients before treatment were counted to analyse the correlation indicators affecting the clinical efficacy of SCIT and to explore whether the two groups The clinical efficacy was evaluated according to the improvement of rhinitis symptoms,and the clinical efficiency of different courses of treatment was compared using the chi-square test to explore the relationship between different courses of treatment and the efficacy of SCIT;adverse events during SCIT treatment were recorded to evaluate its safety.Results:A total of 80 patients were included in this study,including 10 cases in the SRs group and 70 cases in the nSRs group.There was a statistically significant difference in all scores before and after SCIT treatment(p<0.05);there was no difference in the scores between the SRs and nSRs groups,and there was no correlation between the efficacy of SCIT and the occurrence of systemic adverse reactions;there was no correlation between gender,history of smoking or passive smoking,severity of disease,combination of multiple allergens,history of drug allergy and family history of allergy and the efficacy of SCIT treatment.There was a statistically significant difference in the clinical effectiveness rate between adults and children after 2 years of treatment(P<0.05);the overall effectiveness rate after 6 months and 2 years of SCIT treatment was 62.5%and 95%,respectively.75.9%of rapid-onset local adverse reactions,0.2%of Grade Ⅰ systemic adverse reactions and 0.08%of Grade Ⅱ adverse reactions occurred during SCIT treatment,and there were no Grade Ⅲ orⅣ rapid-onset systemic adverse reactions.There were no Grade Ⅲ or Ⅳ rapid-onset systemic adverse reactions.Conclusion:(1)SCIT can effectively treat patients with mite allergic rhinitis,improve symptoms,reduce medication use and improve quality of life.(2)The occurrence of systemic adverse reactions during treatment does not affect its long-term efficacy.(3)Children with AR may have better medium to long-term outcomes than adults.(4)There is no significant difference in the efficacy of SCIT between patients with different levels of disease severity,and it is effective in patients with different levels of severity.(5)The longer the course of SCIT,the more effective it is,suggesting that patients who adhere to long-term treatment are more likely to benefit.