Quality of life in allergic rhinitis and impact of high-dose sublingual immunotherapy: a real-life study

Abstract

Allergic rhinitis (AR) may significantly impair quality of life (QoL), and therefore it is important to evaluate the effectiveness of the available treatments on such a parameter. We studied QoL by a real-life model in a large group of patients with rhinitis caused by the most common aeroallergens and assessed the effects of high-dose sublingual immunotherapy (SLIT). An overall number of 452 subjects (229 males, 223 females, mean age 25 ± 13 years) was included in the study. Of them, 208 were allergic to house dust mites, 196 to grass pollen, 104 to Parietaria pollen, 48 to olive pollen, 28 to ragweed pollen, and two to cypress pollen. QoL was measured before and after SLIT with the specific questionnaire Rhinoconjunctivitis Quality-of Life-Questionnaire (RQLQ) introduced and validated by Juniper. At the same time, patients evaluated their clinical status by visual analogue scale (VAS) from 0 (worst) to 10 (best). SLIT was performed by extracts from Stallergenes standardized in index of reactivity (IR) by a build-up phase in 11 days and a maintenance phase with 300 IR three times a week for the duration of the study. All side-effects were registered. The mean RQLQ was 2.93 ± 1.04 before SLIT and 1.50 ± 0.98 after SLIT (P < 0.001), with comparable improvement in the different allergen treatments. The respective mean VAS score was 4.47 ± 2.11 and 6.92 ± 1.64 (P < 0.001). SLIT was completely tolerated in 395 patients (87.4%), while in 57 (12.6%) it gave rise to slight reactions, mostly at the local level in the mouth or in the gastrointestinal tract. High dose SLIT, administered in a clinical model comparable with routine application, provides significant improvement of both clinical status and QoL in patients with AR caused by common aeroallergens.