206 Clinical Effects of Immunotherapy in Patients with Allergic Disease in the National Institute of Respiratory Diseases

BACKGROUND: Previous studies have shown that after the treatment with immunotherapy there is a reduction in the number of visits to emergency services for asthma crisis, a significant improvement in pulmonary function tests: forced vital capacity (FVC), forced expiratory volume percentage in 1 second (FEV1%) and in the percentage of peak expiratory flow (PEF%) and the dose and number of drugs. There is also evidence of decreased response to skin tests and IgE levels with immunotherapy specific to Dermatophagoides pteronyssinus (Dpt). METHODS: The objective of this study was to evaluate the clinical effects of immunotherapy in patients with allergic disease treated at the National Institute of Respiratory Diseases in Mexico City, Mexico. There was a random selection in a prospective study of 99 patients with positive skin tests and more than 18 months of treatment with subcutaneous immunotherapy specific to epithelia, pollens from trees, grasses and weeds; at the beginning and the end of the immunotherapy there was an evaluation of the scale of rhinitis symptoms and asthma control; pulmonary function tests were performed as well (spirometry). RESULTS: At the initial evaluation, 97% of patients presented moderate to severe persistent rhinitis, 80% of patients with asthma was uncontrolled; after 18 months with specific immunotherapy 80% of patients presented moderate intermittent rhinitis and asthma control was achieved in 85% of the patients. The FEV1 average increased from 78% at the beginning to 89% (P < 0.001). The average bump at the beginning of the specific immunotherapy was 12 cm for Dpt, for trees 10 cm, for weeds 8 cm and for grasses 8 cm; at the end of the SIT the average bump for Dpt was 10 cm, trees 2 cm, weeds 1cm and grass 0 cm (P value < 0.01). CONCLUSIONS: The specific subcutaneous immunotherapy had beneficial clinical effects in patients with allergic disease, with significant improvement in pulmonary function tests and reduced positivity in skin tests, specifically for patients who were sensitive to pollens from trees, weeds and grasses.