OBJECTIVETo investigate the clinical efficacy of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) with standardized house dust mite (HDM) extract for persistent allergic rhinitis (PER).

METHODSNinety-eight patients with moderate to severe PER caused by HDM and who completed SCIT (Alutard SQ, ALK-Abell¨®) or SLIT (Chanllergen-Df drops, Wolwo Pharma) regimen for two years were enrolled in this open-label controlled study. The patients were divided into two groups: SCIT group consisted of 40 patients aged 7 to 57 years old [(19.0 ± 2.7) years, x(-) ± s], and SLIT group consisted of 58 patients aged 6 to 50 years old [(17.7 ± 3.2) years]. The nasal symptoms (sneezing, rhinorrhea, nasal obstruction and pruritus) were evaluated using a four-point rating scale (from 0 = absent to 3 = severe) as well as 10 cm-visual analogue scale (VAS). Efficacy of SCIT and SLIT was assessed as the mean change from baseline in nasal symptom scores after 2-year course of immunotherapy, and the results were compared. SAS software version 9.1.3 was applied for statistical analysis.

RESULTSBoth SCIT and SLIT significantly reduced the individual symptom score of sneezing, rhinorrhea, nasal obstruction and pruritus, and the total nasal symptom scores (including 4-point scale and VAS) after 2-year treatment when compared with the baseline (Z value were -3.14, -3.76, -3.09, -3.48, -4.13; -3.63, -3.21, -2.48, -3.56, -3.98, respectively, all P < 0.05). There was no significant difference in decreased mean score of the individual and total nasal symptoms (4-point scale) between SCIT and SLIT groups (Z value were -0.97, -0.67, -0.36, -0.04, -0.67, respectively, all P > 0.05). However, a significant reduction of VAS score of nasal obstruction was found in SCIT group after 2-year treatment, compared with SLIT group (t = -2.21, P = 0.032). There was no significant difference in decreased VAS score of three other nasal symptoms as well as global rhinitis severity between two immunotherapy groups (t value were -0.57, -1.93, -1.73, -0.99, respectively, all P > 0.05).

CONCLUSIONSBoth SCIT and SLIT demonstrated clinical improvement in moderate to severe PER patients sensitized to HDM after two years treatment. It is suggested that SCIT may relieve nasal obstruction significantly; however, the overall clinical efficacy is consistent with SCIT and SLIT.