Am J Rhinol Allergy:皮下免疫疗法治疗局部过敏性鼻炎的疗效和安全性分析

2021-11-20 AlexYang MedSci原创

评估了皮下免疫疗法治疗LAR患者的疗效和安全性。

局部过敏性鼻炎(LAR),或称 "entopy",是一种新的鼻炎表型,其特点是局部的鼻腔过敏反应,且无全身性过敏情况。LAR的病理特征与Th2鼻腔炎症模式有关,包括鼻粘膜局部产生sIgE和对特定吸入性过敏原的鼻腔过敏源激发试验(NAPT)阳性

皮下免疫疗法(SCIT)已用于治疗局部过敏性鼻炎(LAR)患者。然而,其临床疗效和安全性仍受到质疑。

近期,来自华中科技大学同济医学院的研究人员在《Am J Rhinol Allergy》上发表文章,通过荟萃分析评估了皮下免疫疗法治疗LAR患者的疗效和安全性

研究人员系统地检索了MEDLINE、Cochrane图书馆和Embase出版物。纳入了过敏原免疫疗法(AIT)治疗LAR的疗效和安全性的随机、双盲、临床试验。经过偏倚和异质性评估后,对4个临床终点(综合症状和药物评分[CSMS]、症状评分[SS]、药物评分[MS]和鼻结膜炎生活质量问卷[RQLQ])和不良事件(AEs)进行了荟萃分析,并对免疫学反应结果进行了总结。

研究最终纳入了4项RCTs,共包括134名患者。研究纳入的四项研究用于分析主要结果(CSMS、SS、MS)和AEs,其中三项用于分析RQLQ结果。结果表明,SCIT组和安慰剂组之间存在重要的显著差异,即CSMS(SMD=-2.42,95%CI:-3.60至-1.25,P<0.0001),SS(SMD=-2.08,95%CI:-3.68至-0.48,P=0.01),MS(SMD=-1.43,95%CI:-2.65至-0.21,P=0.02),RQLQ(SMD=-0.70,95% CI -1.29至-0.12,P=0.02),局部AEs(RR=4.13,95% CI 1.08至15.77,P=0.04)。在免疫学反应方面,SCIT后观察到血清sIgG4水平明显提高,过敏原耐受性有所改善。

SCIT在减少综合症状和药物评分中的效果

综上所述,他们的荟萃分析表明,SCIT对改善LAR患者的症状和减少药物使用有明显效果。但仍旧需要更大规模和多中心的临床试验来阐明其安全性和长期疗效。

原始出处:

Wanting Zhu , Pei Gao , Qidi Zhang et al. Efficacy and Safety of Subcutaneous Immunotherapy for Local Allergic Rhinitis: A Meta-Analysis of Randomized Controlled Trials. Am J Rhinol Allergy. Oct 2021

 

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    2021-11-21 膀胱癌
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    2021-11-21 chg122

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