[Safety of subcutaneous immunotherapy with tyrosine-adsorbed house dust mite extracts in patients with allergic disease]

Rev Alerg Mex. Jan-Mar 2017;64(1):52-65. doi: 10.29262/ram.v64i1.233.
[Article in Spanish]

Abstract

Background: In spite of allergen-specific immunotherapy (SIT) multiple benefits, its use is restricted in some countries owing to concerns about severe adverse reactions.

Objective: To evaluate systemic adverse reactions in patients with atopic dermatitis, allergic asthma, allergic rhinitis and allergic conjunctivitis who received subcutaneous immunotherapy with tyrosine-adsorbed Dermatophagoides and Glycyphagoides dust mites extracts.

Methods: Retrospective study of the 2010-2015-period that included 773 patients diagnosed with IgE-mediated diseases, where the safety of allergen-specific immunotherapy was described according to the World Organization of Allergy subcutaneous immunotherapy-induced systemic reactions classification system.

Results: 79.7 % of patients had rhinitis, 54.9 % asthma, 34.5 % conjunctivitis and 16.4 % atopic dermatitis. Out of 12,546 tyrosine-adsorbed extract doses, 45 systemic reactions were recorded: 12 were grade 1 (30 %), 27 grade 2 (67.5 %) and 1 was grade 3 (2.5 %); the reaction rate was 0.35 per 100 administered injections, for an incidence rate of 5.8 %. No fatal reactions occurred.

Conclusion: The frequency of systemic reactions with subcutaneous immunotherapy with Dermatophagoides farinae, Dermatophagoides pteronyssinus and Blomia tropicalis tyrosine-adsorbed extracts was similar to that reported with other extracts.

Antecedentes: Pese a los múltiples beneficios de la inmunoterapia alérgeno-específica, en algunos países se restringe su uso por temor a las reacciones adversas severas. Objetivo: Evaluar las reacciones sistémicas adversas en pacientes con dermatitis atópica, asma, rinitis y conjuntivitis alérgicas, que recibieron inmunoterapia subcutánea con extractos tirosinados para ácaros Dermatophagoides y Glycyphagoides. Métodos: Estudio retrospectivo del periodo 2010-2015 en el que se incluyó a 773 pacientes con diagnóstico de enfermedades mediadas por IgE. Se describió la seguridad de la inmunoterapia alérgeno-específica conforme al sistema de clasificación de las reacciones sistémicas con inmunoterapias subcutánea de la Organización Mundial de Alergias. Resultados: 79.7 % de los pacientes presentó rinitis, 54.9 % asma, 34.5 % conjuntivitis y 16.4 % dermatitis atópica. De 12 546 dosis subcutánea con extractos tirosinados se registraron 45 reacciones sistémicas: 12 grado 1 (30 %), 27 de grado 2 (67.5 %) y 1 grado 3 (2.5 %); la tasa de reacción fue de 0.35 por cada 100 inyecciones administradas, que representó una incidencia de 5.8 %. No se registraron reacciones fatales. Conclusión: Con la inmunoterapia subcutánea con extractos tirosinados de Dermatophagoides farinae, Dermatophagoides pteronyssinus y Blomia tropicalis se presentó una frecuencia de reacciones sistémicas similar a la informada con otros extractos.

Keywords: Allergy; Dermatophagoides; Immunotherapy; Respiratory disease.

MeSH terms

  • Adolescent
  • Adsorption
  • Animals
  • Antigens, Dermatophagoides / administration & dosage
  • Antigens, Dermatophagoides / adverse effects*
  • Antigens, Dermatophagoides / chemistry
  • Antigens, Dermatophagoides / therapeutic use
  • Asthma / therapy
  • Child
  • Child, Preschool
  • Conjunctivitis, Allergic / therapy
  • Dermatitis, Atopic / therapy
  • Dermatophagoides pteronyssinus / immunology
  • Desensitization, Immunologic / adverse effects*
  • Dose-Response Relationship, Immunologic
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Rhinitis / therapy
  • Tyrosine

Substances

  • Antigens, Dermatophagoides
  • Tyrosine