用于治疗HDM过敏性鼻炎和哮喘的SQ HDM舌下免疫治疗片可改善主观嗜睡和失眠:真实生活 CARIOCA 研究的探索性分析。

IF 6.1 3区 医学 Q1 ALLERGY Journal of Investigational Allergology and Clinical Immunology Pub Date : 2024-10-23 Epub Date: 2023-09-04 DOI:10.18176/jiaci.0934
D Jaffuel, E Serrano, C Leroyer, A Chartier, P Demoly
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引用次数: 0

摘要

背景:有关屋尘螨(HDM)舌下免疫疗法(SLIT)对过敏性鼻炎(AR)和哮喘相关睡眠障碍的疗效的了解仍不全面。我们开展了一项非干预性研究,以评估标准化质量(SQ)HDM SLIT 片剂对由 HDM 引起的呼吸道过敏成人的安全性和症状的影响。该研究还评估了接受 SQ HDM SLIT 片剂治疗的 AR 和/或哮喘相关睡眠障碍患者的失眠和白天嗜睡状况:这是一项为期 12 个月的多中心、纵向和前瞻性研究。参与者开始服用 SQ HDM SLIT 片剂的原因是:中度至重度 HDM 引起的哮喘,尽管使用了缓解症状的药物,但症状仍持续存在;或 HDM 引起的哮喘相关睡眠障碍,吸入皮质类固醇不能很好地控制,且与轻度至重度 HDM 引起的哮喘相关。睡眠症状采用失眠严重程度指数(ISI)问卷和埃普沃思嗜睡量表(ESS)进行测量:共有 1526 名成年患者参与研究,最终有 1483 人被纳入分析。基线时,41.5%的患者报告有睡眠障碍,其中77.0%的患者失眠,28.9%的患者白天过度嗜睡。失眠症在未控制的 AR 患者中的发生率(83.1%)明显高于在控制的 AR 患者中的发生率(52.6%):在现实生活中,对于 HDM 引起的 AR 和/或哮喘相关睡眠障碍患者,使用 SQ HDM SLIT 片剂治疗 1 年后,主观失眠和嗜睡情况有所改善。
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SQ HDM Sublingual Immunotherapy Tablet for the Treatment of HDM Allergic Rhinitis and Asthma Improves Subjective Sleepiness and Insomnia: An Exploratory Analysis of the Real-life CARIOCA Study.

Background: Knowledge of the effectiveness of house dust mite (HDM) sublingual immunotherapy (SLIT) in allergic rhinitis (AR) and asthma associated sleep disorders remains incomplete. A noninterventional study was conducted to assess the effect of the standardized quality (SQ) HDM SLIT tablet on safety and symptoms in adults with respiratory allergies caused by HDM. The study also assessed the status of insomnia and daytime sleepiness in patients with AR and/or asthma-associated sleep disorders treated with the SQ HDM SLIT tablet.

Methods: This was a 12-month multicenter, longitudinal, and prospective study. Participants started the SQ HDM SLIT tablet for moderateto-severe HDM-induced AR that was persistent despite the use of symptom relieving medication or HDM-induced asthma-associated sleep disorders that were not well controlled with inhaled corticosteroids and were associated with mild-to-severe HDM-induced AR. Sleep symptoms were measured using the Insomnia Severity Index (ISI) questionnaire and the Epworth Sleepiness Scale (ESS).

Results: A total of 1526 adult patients were enrolled, and 1483 were eventually included in the analysis. At baseline, 41.5% of patients reported sleep disorders; of these, 77.0% had insomnia and 28.9% experienced excessive daytime sleepiness. Insomnia was significantly more frequent among patients with uncontrolled AR (83.1%) than among those with controlled AR (52.6%) (P<.0001). Over time, 48.3% and 59.7% of patients, respectively, reported an improvement greater than the minimal clinically important difference in the ISI and ESS scales.

Conclusion: In patients with HDM-induced AR and/or asthma-associated sleep disorders, an improvement in subjective insomnia and sleepiness was observed after 1 year of treatment with the SQ HDM SLIT tablet in a real-life setting.

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来源期刊
CiteScore
7.10
自引率
9.70%
发文量
135
审稿时长
6-12 weeks
期刊介绍: The Journal of Investigational Allergology and Clinical Immunology (J Investig Allergol Clin Immunol) provides an attractive and very active forum for basic and clinical research in allergology and clinical immunology.Journal of Investigational Allergology and Clinical Immunology publishes original works, reviews, short communications and opinions.
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