Clinical Features of Patients in Remission after House Dust Mite Allergen Immunotherapy in Adult Asthma

Abstract

Background: Although allergen specific immunotherapy has been used as the only curative treatment for allergic diseases, there have been few studies that observed the efficacy of immunotherapy in asthmatics. Objectives : We attempted to determine clinical parameters for predicting the remission of asthma after immunotherapy with house dust mite extracts. Methods: Fifty-six adult asthmatic patients undergoing immunotherapy with house dust mite extracts for more than 3 years were enrolled. They were classified into the remitted and unremitted group according to the results of following methacholine challenge test. Skin reactivity, immunologic findings, spirometry, and airway hyperreactivity were compared between the 2 groups. Results: Twenty-six subjects (46.4%) were in the remitted group and 30 subjects (53.6%) were in the unremitted group. Both onset age of asthma symptoms and starting age of immunotherapy were significantly lower in the remitted group (P<0.05, for each). Baseline FEV1 levels and degree of airway hyperreactivity were significantly better in the remitted group (P<0.01 and 0.05, respectively). Conclusion: Younger age, earlier immunotherapy as well as better lung function and airway hyperreactivity at baseline can be used to predict the remission of asthma in adults. Therefore, earlier allergen immunotherapy in younger age group might help achieve remission in adult allergic asthma.