Comparisons between injection and sublingual immunotherapy for rhinitis and asthma in allergic children to house dust mite or parietaria pollen. A case controlled study

Abstract

Rationale We have compared clinical and laboratory data from two immunotherapy trials performed with house dust mites and Parietaria pollen. Methods Two open case-controlled studies one (Parietaria pollen) employing injection (SCIT n. 21), high dose (twenty five times Scit dose) sublingual (SLIT n. 24) and control group (n. 18); the other (D. Pteronyssinus) employing injection (n. 25) high dose (thirty times Scit dose) sublingual (SLIT n. 28) and control group (n. 20). The Ethical Committee of our hospital not allows us to carry on with a double blind–double dummy study. Administration of allergen was performed in parallel during 2000 and 2001. Results House Dust Mite groups: When compared with the respective control group combined symptom, medication scores were 63% lower (p=0,06) after SCIT and 56% lower (p=0,07) after SLIT. Serum allergen specific IgG4 antibodies (mean SD) increased 14 fold following SCIT compared with 12 fold increase SLIT. There were no significant changes in the placebo group. Parietaria judaica groups: When compared with the respective control group combined symptom/medication scores were 65% lower (p=0,005) after SCIT and 43% lower (p=0,07) after SLIT. Serum allergen specific IgG4 antibodies (mean SD) increased 13 fold following SCIT compared with 7 fold increase following SLIT. There were no significant changes in the placebo group. Conclusions Although compared only with control group this trial shows not difference between SCIT and SLIT for house dust mite extract. The Parietaria subcutaneous vaccine has, in the doses used, a clinical efficacy around 34% greater than sublingual vaccine.