キーワード : は じ め に 対象と方法

Transcription

1 : IgE CAP : IgE CAP

2 /

3 / / / WAO World Allergy Organization () 2 IgE CAP Mann Whitney U IgE Mann Whitney U

4 Mann Whitney U 5 meansdmann Whitney U

5 Grastek Oralair Oralair Grastek n207 n266 Oralair n1038 Grastek n1669

6 IgE Yuta A, Ogihara H, Yamanaka K, et al : Therapeutic outcomes and immunological effects of sublingual immunotherapy for Japanese cedar pollinosis. Clin Exp Allergy Rev 2012 ; 12 : :. ; :. : QOL. ; :. Okubo K, Gotoh M, Fujieda S, et al : A randomized doubleblind comparative study of sublingual immunotherapy for cedar pollinosis. Allergol Int 2008 ; 57 : Canonica GW, Cox L, Pawankar R, et al : Sublingual immunotherapy : World Allergy Organization position paper 2013 update. World Allergy Organ J ; 7 : 6. doi : / Okamoto Y, Okubo K, Yonekura S, et al : Efficacy and safety of sublingual immunotherapy for two seasons in patients with Japanese cedar pollinosis. Int Arch Allergy Immunol 2015 ; 166 : MERCK : Grastek prescribing information. https : // grastek_pi.pdf,. U.S. Food and Drug Administration : Oralair prescribing information. http ://www. fda. gov / downloads / BiologicsBloodVaccines / Allergenics / UCM pdf,. Passalacqua G1, BaenaCagnani CE, Bousquet J, et al : Grading local side effects of sublingual immunotherapy for respiratory allergy : speaking the same language. J Allergy Clin Immunol 2013 ; 132 : Nelson HS : Subcutaneous immunotherapy versus sublingual immunotherapy : which is more effective? J Allergy Clin Immunol Pract 2014 ; 2 : Chelladurai Y1, Lin SY : Effectiveness of subcutaneous versus sublingual immunotherapy for allergic rhinitis : current update. Curr Opin Otolaryngol Head Neck Surg

7 ; 22 : :. J=STAGE, https :// jjrhi/53/4/53_579/_pdf,. Wise SK, Schlosser RJ : Subcutaneous and sublingual immunotherapy for allergic rhinitis : what is the evidence? Am J Rhinol Allergy 2012 ; 26 : 1822 Wise SK, Schlosser RJ : Evidencebased practice : sublingual immunotherapy for allergic rhinitis. Otolaryngol Clin North Am 2012 ; 45 : Blazowski L1 : Anaphylactic shock because of sublingual immunotherapy overdose during third year of maintenance dose. Allergy 2008 ; 63 : 374. Rienzo VD1, Minelli M, Musarra A, et al : Postmarketing survey on the safety of sublingual immunotherapy in children below the age of 5 years. Clin Exp Allergy 2005 ; 35 : Passalacqua G, Villa G, Altrinetti V, et al : Sublingual swallow or spit? Allergy 2001 ; 56 : 578. Jerschow E, Lin RY, Scaperotti MM, et al : Fatal anaphylaxis in the United States, : temporal patterns and demographic associations. J Allergy Clin Immunol 2014 ; 134 : Adverse Events of Sublingual Immunotherapy in 207 Patients with Japanese Cedar Pollinosis Yukiko Ogawa, M.D., Atsushi Yuta, M.D., Masahiko Arikata, M.D. Hideaki Kozaki, M.D.,NobuoOhta,M.D., Yusuke Suzuki, M.D. and Takeshi Shimizu, M.D. Yuta Clinic, Tsu Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu Yamagata City Hospital, Yamagata Sublingual immunotherapyslitfor Japanese cedar pollinosis is effective, however, caution must be exercised against allergenspecific adverse eventsaesduring SLIT. Purpose : The purpose of this study was to clarify the AEs of SLIT in a large cohort of patients with Japanese cedar pollinosis. Methods : We conducted a detailed survey, by both questionnaires and direct interviews, of 207 patients receiving SLIT at our clinic. Results : Eightyfour of the 207 patients40.5%developed AEs, with AEs involving the oral cavity and throat being the most common56 patients ; 27.1%. Sixteen patients7.9%had local mucosal swelling, but the swelling resolved in all the cases. Other allergeninduced symptoms such as nasal symptoms29 events, 14.0%, eye symptoms14 events, 6.8%and ear symptoms20 events, 9.7%were also recognized. All the AEs were minor, and discontinuation of SLIT was not necessitated in any of the patients because of AEs. There were 52 AEs25.0%in the updose phase and 61 AEs29.3%in the maintenance phase. However, only 4 of the 161 patients2.5%developed AEs during the pollen season. Most AEs developing during the maintenance phase occurred in the first few weeks. In 60% of the cases, the AEs disappeared within 2 weeks, and in 6.0%5 events, they persisted for longer than 2 months. There were no ageor sex related differences in the prevalence of cedar pollenspecific IgE, or in the adherence to the treatment. Conclusion : AEs in SLIT were shown in many patients, however, the severity of AEs was mild and no events interfered SLIT. Keywords : sublingual immunotherapy, adverse event, Japanese cedar pollinosis Nippon Jibiinkoka Gakkai KaihoTokyo118 : , 2015