“Simplified local nasal immunotherapy in mite dust allergic rhinitis”

AIM The present work aimed at evaluating the efficacy and the tolerance of an alternative schedule of local nasal immunotherapy for the treatment of mite dust allergic rhinitis. The authors suggested the nasal administration of the maximum tolerated dosage chosen on the basis of nasal provocation test threshold, comparing allegen extracts in micronized powder and watery solution. SUBJECTS AND METHOD Forty-five patients (25 men and 20 women), aged 18 to 66 years, affected by allergic rhinitis to Dermatophagoides (Dpt) were selected and treated either by local immunotherapy in watery solution (15) or in powder form (15) or by parenteral specific hyposensitizing treatment (15). RESULTS Before and one year after the beginning of the study, the clinical diaries, total and specific IgE variation were evaluated. The monthly symptoms and the drug use were comparable among the three treatment groups. No significant difference was found, with the exception of local symptomatology, which improved more in patients undergoing local immunotherapy (p>0.05); and oral antihistamine use, which was lower in patients treated with the watery solution (p<0.005). CONCLUSIONS Local simplified hyposensitizing treatment was able to combine the absence of symptomatological worsening with the decrease of both local and systemic drug use. The advantage of the LNIT protocol proposed herein are the follows: simplified schedule for self-administration; improved patient compliance; reduction of local side effectS; clinical efficacy comparable with subcutaneous specific immunotherapy.