Predicting allergen immunotherapy efficacy based on early maintenance phase response in routine clinical practice

Area of Science:

• Allergology and Immunology
• Respiratory Medicine
• Clinical Research

Background:

• Allergen-specific immunotherapy (AIT) is effective but has variable outcomes.
• Predictive markers for AIT response are not well-established.
• Identifying reliable predictors is crucial for optimizing patient treatment.

Purpose of the Study:

• To identify clinical parameters predicting AIT responders in daily practice.
• To evaluate the efficacy of AIT in patients with house-dust-mite-driven asthma/rhinitis.
• To find early indicators of successful long-term AIT.

Main Methods:

• Retrospective analysis of 133 patients undergoing 3 years of subcutaneous AIT.
• Assessment of disease control using estimated daily symptom and medication score (edSMS).
• Definition of responders based on ≥30% edSMS reduction from up-dosing to maintenance III phase.

Main Results:

• Overall improvement in disease condition after 3 years of AIT.
• Responders had lower polysensitization, less tobacco smoke exposure, and milder pretreatment severity.
• Early reduction in edSMS (up-dosing to maintenance I) significantly predicted 3-year AIT outcomes (p < 0.001).
• ΔedSMS_U-M1 > 18.40% predicted responders with 76.20% sensitivity and 76.70% specificity.

Conclusions:

• Individualized clinical responses to AIT present challenges in predicting efficacy.
• Early treatment effectiveness during the maintenance phase is a reliable predictor of 3-year AIT outcomes.
• This study provides a practical clinical indicator for AIT success.