Abstract:
BACKGROUND: Very few studies have evaluated the effects of
sublingual immunotherapy (SLIT) in elderly adults with either
rhinitis or bronchial asthma. The aim of this study was to ascertain
whether SLIT is effective in these patients.
METHODS: One hundred and sixty seven patients (aged 18-65
years) with persistent rhinitis and mild asthma, selected from 573
subjects allergic to house-dust mites, were treated with either
standard chronic pharmacotherapy or SLIT plus drugs on demand.
Monthly symptom/drug scores, respiratory function, methacholine (MCh)
challenge and eosinophil count were scheduled at the beginning and
end of the study.
RESULTS: We analysed two age groups (18-28 years, 49
patients) and 55-65 years, 40 patients). There were no differences
between the groups at baseline but MCh sensitivity was lower in the
older patients. At the end of treatment, SLIT achieved improvement
in all variables (p< 0.001) in both age groups, but the global
symptoms were lower in the younger patients (p=0.0002). There were
also fewer new sensitizations in the SLIT groups (p=0.03) than in
the "control"patients given standard pharmacotherapy, but with no
relation to age. Asthma became worse only in the control groups,
regardless of age.
CONCLUSIONS: SLIT reduces symptoms, drug consumption and
the progression of the disease in both young and elderly subjects
allergic to house-dust mites, with persistent rhinitis and mild
bronchial asthma.
