Burden of allergic respiratory disease: a systematic review.

This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust mite (HDM) versus AR and/or AA caused by seasonal pollen allergy. Following a systematic search, the identified studies used the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease-specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patients' HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective outcomes.

Clinical and patient based evaluation of immunotherapy for grass pollen and mite allergy.

BACKGROUND: Treatment of allergic disease can be done by pharmacological intervention by allergen avoidance--in the following called standard care (SC), or by specific treatment with allergy vaccination; Specific Immunotherapy (SIT). The aim of this study were to evaluate the effects of subcutaneously administrated SIT compared to SC by objective (clinical/medical records) and subjective parameters (patient's opinion) in a before/after SIT study. METHODS: The study included retrospectively all grass- and mite allergic 16-60 year old patients (N = 253) who had started SIT for grass pollen or mite allergy during the period 1.1.1996-1.1.2002 at The Allergy Unit, Aarhus University Hospital, or at a specialist practice in Aarhus. Relevant data were collected before/after treatment from medical records and from a specific designed questionnaire. The following indicators for effect were applied: Success of immunotherapy expressed as completion of up dosing phase, change in symptoms, a comparison of overall rhinoconjunctivitis symptoms, number of symptom free days per year, effect of pharmaceuticals, change in physical and psychological wellbeing and number of lost days from work/education and leisure activities. RESULTS: Compliance for completed up dosing for SIT was 94 % (95 % CI 90-97). The questionnaire revealed that after SIT there were a significant reduction in degree of symptoms, 84 % (95 % CI 79-89) of the respondents achieved a reduction in over all rhinoconjunctivitis score, there were an increase in symptom free days per year, a decrease in days off/incapacity from work/education and leisure activities, an improved effect of the pharmaceuticals used for allergic symptoms and an improvement in physical and psychological wellbeing. The study also showed that SIT was more effective treating rhinoconjunctivitis symptoms than lung symptoms. CONCLUSION: The study revealed great advantages of SIT compared to SC and a high compliance for SIT during the up dosing period.

Clinical and patient based evaluation of immunotherapy for grass pollen and mite allergy

Background: Treatment of allergic disease can be done by pharmacological intervention by allergen avoidance ­ in the following called standard care (SC), or by specific treatment with allergy vaccination; Specific Immunotherapy (SIT). The aim of this study were to evaluate the effects of subcutaneously administrated SIT compared to SC by objective (clinical/medical records) and subjective parameters (patient's opinion) in a before/after SIT study. Methods: The study included retrospectively all grass- and mite allergic 16-60 year old patients (N = 253) who had started SIT for grass pollen or mite allergy during the period 1.1.1996-1.1.2002 at The Allergy Unit, Aarhus University Hospital, or at a specialist practice in Aarhus. Relevant data were collected before/after treatment from medical records and from a specific designed questionnaire. The following indicators for effect were applied: Success of immunotherapy expressed as completion of up dosing phase, change in symptoms, a comparison of overall rhinoconjunctivitis symptoms, number of symptom free days per year, effect of pharmaceuticals, change in physical and psychological wellbeing and number of lost days from work/education and leisure activities. Results: Compliance for completed up dosing for SIT was 94 % (95 % CI 90-97). The questionnaire revealed that after SIT there were a significant reduction in degree of symptoms, 84 % (95 % CI 79-89) of the respondents achieved a reduction in over all rhinoconjunctivitis score, there were an increase in symptom free days per year, a decrease in days off/incapacity from work/education and leisure activities, an improved effect of the pharmaceuticals used for allergic symptoms and an improvement in physical and psychological wellbeing. The study also showed that SIT was more effective treating rhinoconjunctivitis symptoms than lung symptoms. Conclusion: The study revealed great advantages of SIT compared to SC and a high compliance for SIT during the up dosing period

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