Comparative evaluation of the efficacy, safety and economic costs high dose and lowdose allergen specific immunotherapy with pharmacological therapy in patients with atopic bronchial asthma
The purpose of research a comparative evaluation of the efficiency and safety of lowdose oral allergovaccines AV1P and AV2P with l highdose oral and subcutaneous allergen specific immunotherapy (ASIT) in patients with atopic brochial asthma (ABA).
Methods. The study involved 213 patients with ABA. Treatment was carried out in groups: highdose oral allergovaccine “Domal”, lowdose oral allergovacines AV1P and AV2P, subcutaneous ASIT, drugs according to protocol asthma, placebo. We studied the efficiency of the therapy on a 4point rating scale, the dynamics of skin sensitization to the allergen, the level of IgEantibodies in the serum of patients.
Results. Treatment of highdose oral allergovaccine “Domal” and lowdose oral allergovaccines AV1P and AV 2P was more effective as compared with subcutaneous ASIT (r = 0.04, p = 0.004 , p = 0.04) and pharmacotherapy (p = 0.04; p = 0.005; p = 0.01). In all groups, the efficiency of treatment was was higher than placebo. ASIT modulated serum level of specific IgE and reduction of allergen induced early cutaneous responses (p <0,05). The frequency of adverse reactions, their severity and duration of an oral highdose and lowdose ASIT were lower compared to subcutaneous ASIT (p <0,05). The cost of treatment with lowdose oral allergovaccines 10 times smaller than the oral highdose allergovaccine “Domal” and 3 times less subcutaneous ASIT.
Conclusions. Oral administration of high and low doses of allergens induces imunological tolerance, highly secure, easy to use. The additional benefit of lowdose oral allergovaccines is their low cost. The use of lowdose oral allergovaccines is an effective method of pathogenetic treatment of atopic brochial asthma.