Background/Aims: Allergic rhinitis (AR) in the elderly patients is constantly increasing with the extension of life expectancy, but little is known about elderly AR. Immunotherapy in the elderly patients is a controversial issue since no proven evidence in the safety and efficacy of this treatment had been shown. In this study, we were to find the characteristics of elderly AR sensitized to house dust mite (HDM) and evaluate the safety and efficacy of sublingual allergen-specific immunotherapy.
Total 21 patients older than 60 years old with AR sensitized to HDM with A/H ratio of >3 on skin prick test and/or >0.35IU/L in ImmunoCAP to D.farinae and D.pteronyssinus were enrolled in this study. The patients were randomized to either medication group with LAIS® Mites Sublingual tablets (2/week) or observation group using a double-blind method in their first visit and their symptoms and adverse reactions were monitored for 3 months.
Of 21 patients, 13 (61.9%) patients were in the medication group and 8(38.1%) patients were in the observation group. Regardless of the groups, the mean age was 67.2 years, the ratio of male to female patients was 11(52.4%) to 10 (47.6%). The mean of total IgE was 601.1IU/L and specific IgE to D.farinae and D.pteronyssinus were 4.8IU/L and 11.72IU/L, respectively. The baseline mean value of total rhino-conjunctivitis symptom score, which is a primary endpoint of this study, was 22.09, which tended to decrease during 3 months. Serious adverse events have not been reported, and the patients are well tolerated with LAIS®.
Sublingual immunotherapy with tablet form in elderly AR patients sensitized to HDM is worth trying and no safety issue has become a problem, but further investigation results are needed.
This study was supported by Lofarma SpA, Milano, Italy.