Specific Immunotherapy with Standardized Latex Extract versus Placebo in Latex-Allergic Patients

• Published in: International Archives of Allergy and Immunology 2006-01, Vol.141 (4), p.369-376
• Main Authors: Tabar, Ana Isabel, Anda, Marta, Bonifazi, Floriano, Bilò, Maria Beatrice, Leynadier, Francisque, Fuchs, Thomas, Ring, Johannes, Galvain, Sylvie, André, Claude
• Format: Article
• Language: English
• Subjects: Adult; Allergic diseases; Allergies; Biological and medical sciences; Clinical outcomes; Desensitization, Immunologic - adverse effects; Desensitization, Immunologic - methods; Double-Blind Method; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunoglobulin E - blood; Immunoglobulin G - blood; Immunopathology; Immunotherapy; Latex - immunology; Latex Hypersensitivity - therapy; Male; Medical sciences; Middle Aged; Original Paper; Rubber products; Skin allergic diseases. Stinging insect allergies; Skin Tests
• ISSN: 1018-2438; 1423-0097; 1365-2567
• DOI: 10.1159/000095463

Background: Allergy to natural rubber latex proteins continues to be an important medical problem among health care professionals, but also in multioperated children. Clinical manifestations range from urticaria to angioedema, rhinoconjunctivitis, bronchial asthma and anaphylactic shock. Methods: The aim of this study was to investigate the efficacy and safety of a 12-month latex-specific immunotherapy in sensitized patients, most often health care workers. Twenty-three patients with latex rhinoconjunctivitis (20 of whom also had asthma) were included in this randomized, double-blind, placebo-controlled trial (11 in the active group, 12 in the placebo group). Treatment efficacy was assessed by means of symptom and medication scores. Conjunctival provocation tests and quantitative skin prick tests were also performed. Results: The clinical index (derived by combining changes from baseline of six efficacy variables during the treatment period) did not differ significantly between treatment groups. Change from baseline of rhinitis, conjunctivitis, skin symptoms, asthma symptoms, medication score and cutaneous reactivity were not significantly different between the two groups. A nonsignificant difference in conjunctival reactivity was observed in favor of the active group (p = 0.09). Systemic reactions were much higher in the specific immunotherapy than in the placebo group. Conclusions: The present study failed to show a significant improvement of symptoms and medication scores, probably because of the low level of symptoms at baseline and the low maintenance dose of therapy, even if allergen-specific conjunctival reactivity decreased in the active group. Moreover, the incidence of systemic reactions was very high in the active group.