Pengaruh Dermatitis Atopik, Urtikaria dan Gangguan Saluran Cerna sebagai Komorbiditas dalam Perbaikan Klinis dan Kepuasan Orang Tua Pasien pada Anak Alergi dengan Gejala Saluran Nafas Tingkat Moderate-Persistent yang Mendapatkan Imunoterapi Alergen Debu Rumah
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Latar Belakang: Rendahnya efektivitas imunoterapi dan kepuasan orang tua perlu dieksplorasi untuk menurunkan angka dropout imunoterapi yang masih tinggi. Tujuan: mengevaluasi pengaruh keberadaan gejala alergi di luar saluran nafas pada efektivitas imunoterapi dalam meredakan gejala alergi dan kepuasan para orang tua. Metode: Penelitian dilaksanakan mulai 1 Januari 2008 sampai 31 Desember 2018 dengan disain kohort retropektif pada anak alergi debu rumah dengan gejala saluran nafas moderate-persistent yang diberikan imunoterapi alergen debu rumah subkutan. Setelah fase rumatan imunoterapi selesai, tingkat gangguan kualitas hidup dan frekuensi gejala, jumlah hari/minggu bebas gejala alergi, dan tingkat kepuasan orang tua dievaluasi dalam 30 hari. Hasil: Sejumlah 100 % dari total subjek penelitian (2,171 pasien) sensitif pada alergen debu rumah dengan gejala saluran nafas. Sebesar 79,7 % pasien membaik menjadi mild-intermittent. Rerata jumlah hari bebas gejala pada 30 hari paska fase rumatan imunoterapi adalah 25,1 + 8,31 hari. Tingkat kepuasan yang tinggi dinyatakan oleh 72,9 % orangtua pasien. Adanya komorbiditas dermatitis atopik, urtikaria, dan gejala alergi saluran cerna tidak berpengaruh terhadap skor perbaikan gejala alergi saluran nafas. Keberadaan dermatitis atopik, urtikaria, dan gangguan saluran cerna berkorelasi dengan penurunan jumlah hari bebas gejala. Simpulan: Keberadaan dermatitis atopik, urtikaria, dan gangguan saluran cerna sebagai komorbiditas tidak menurunkan efektivitas imunoterapi alergen debu rumah dalam meredakan gejala alergi saluran nafas, tetapi menurunkan jumlah hari/minggu bebas dari gejala alergi dan tingkat kepuasan orang tua pasien.
Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med 2017; 5(9): 691–706.
Ha EK, Na MS, Lee S, Baek H, Lee SJ, Sheen YH, et al. Prevalence and clinical characteristics of local allergic rhinitis in children sensitized to house dust mites. Int Arch Allergy Immunol 2017; 174(3-4): 183-9.
Lim FL, Hashim Z, Than LT, Said MD, Hashim H, Norback D. Asthma, airway symptoms and rhinitis in office workers in Malaysia: associations with house dust mite (hdm) allergy, cat allergy and levels of house dust mite allergens in office dust. PLoS One 2015; 10(4): 1-21.
A R, Baranwal AK. Child with allergies or allergic reactions. Indian J Pediatr 2018; 85(1): 60-65.
Devdas JM Mckie C, Fox AT, Ratageri VH. Food allergy in children: an overview. Indian J Pediatr 2018; 85(5): 369-74.
Gray CL, Levin ME, Du Toit G. Respiratory comorbidity in South African children with atopic dermatitis. S Afr Med J 2017; 107(10): 904-9
Calderón MA, Kleine TJ, Linneberg A, De Blay F, Hernandez Fernandez de Rojas D, Virchow JC, et al. House dust mite respiratory allergy: an overview of current therapeutic strategies. J Allergy Clin Immunol Pract 2015; 3(6): 843-55.
Horak F. Respiratory allergies in children and adolescents: the role of component-resolved diagnosis and specific immunotherapy. Wien Med Wochenschr 2015; 165(17-18): 347-53.
Hankin CS, Cox L, Lang D, Bronstone A, Fass P, Leatherman B, et al. Allergen immunotherapy and health care cost benefits for children with allergic rhinitis: a large-scale, retrospective, matched cohort study. Ann Allergy Asthma Immunol 2010; 104(1): 79-85.
Abramson MJ, Puy RM, Weiner JM. Injection allergen immunotherapy for asthma. Cochrane Database Syst Rev 2010; (8): 1-90
Passalacqua G. Specific immunotherapy in asthma: a comprehensive review. J Asthma 2014; 51(1): 29–33.
Saporta D. Efficacy of sublingual immunotherapy versus subcutaneous injection immunotherapy in allergic patients. J Environ Public Health 2012; 6: 1-6
Musa F, Al-Ahmad M, Arifhodzic N, Al-Herz W. Compliance with allergen immunotherapy and factors affecting compliance among patients with respiratory allergies. Hum Vaccin Immunother 2017; 13(3): 514-7
Hommers L, Ellert U, Scheidt-Nave C, Langen U. Factors contributing to conductance and outcome of specific immunotherapy: data from the German National Health Interview and Examination Survey 1998. Eur J Public Health 2007; 17: 278–84
Gelincik A, Demir S, Olgaç M, Ä°şsever H, Khishigsuren B, Özşeker F, et al. High adherence to subcutaneous immunotherapy in a real-life study from a large tertiary medical center. Allergy Asthma Proc 2017; 38(6): 78-84.
Roger Reig A, Ibero Iborra M, Carrillo Díaz T, López Abad R, Sánchez Moreno V, Álvarez Nieto J, et al. Perceived efficacy and satisfaction of patients with subcutaneous hypoallergenic high-dose house dust mite extract. Eur Ann Allergy Clin Immunol 2017; 49 (3):100-5.
Lemberg ML, Berk T, Shah-Hosseini K, Kasche EM, Mösges R. Sublingual versus subcutaneous immunotherapy: patient adherence at a large German allergy center. Patient Prefer Adherence 2017; 4(11): 63-70
Wyrzykowska N, Czarnecka-Operacz M, Adamski Z. Long-term efficacy of allergen specific immunotherapy in atopic dermatitis patients in relation to quality of life. Eur Ann Allergy Clin Immunol 2015; 47(1): 5-9
Flatin MC, Ade S, Hounkpatin SH, Ametonou B, Vodouhe UB, Adjibabi W. Symptoms of allergic rhinitis in Parakou, Benin: Prevalence, severity and associated factors. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135(1): 33-6.
Nankervis H, Pynn EV, Boyle RJ, Rushton L, Williams HC, Hewson DM, et al. House dust mite reduction and avoidance measures for treating eczema. Cochrane Database Syst Rev 2015; 19(1): 1-22
Manam S, Tsakok T, Till S, Flohr C. The association between atopic dermatitis and food allergy in adults. Curr Opin Allergy Clin Immunol 2014; 14(5): 423-9.
Nahm DH, Kim ME,Kwon B, Cho SM, Ahn A. Clinical efficacy of subcutaneous allergen immunotherapy in patients with atopic dermatitis. Yonsei Med J 2016; 57(6): 1420-6.
Eichenfield LF, Ahluwalia J, Waldman A, Borok J, Udkoff J, Boguniewicz M. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the joint task force practice parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol 2017; 139(4S): S49-S57.
Radonjic-Hoesli S, Hofmeier KS, Micaletto S, Schmid-Grendelmeier P, Bircher A, Simon D. Urtikaria and angioedema: an update on classification and pathogenesis. Clin Rev Allergy Immunol 2018; 54(1): 88-101.
Kulthanan K, Tuchinda P, Chularojanamontri L, Chanyachailert P, Korkij W, Chunharas A, et al. Clinical practice guideline for diagnosis and management of urtikaria. Asian Pac J Allergy Immunol 2016; 34(3): 190-200
Nowak-Wegrzyn A, Szajewska H, Lack G. Food allergy and the gut. Nat Rev Gastroenterol
Hepatol 2017; 14(4): 241-57
Roca-Saavedra P, Mendez-Vilabrille V, Miranda JM, Nebot C, Cardelle-Cobas A, Franco CM, et al. Food additives, contaminants and other minor components: effects on human gut microbiota-a review. J Physiol Biochem 2018;74(1): 69-83.
Hankin CS, Lockey RF. Patient characteristics associated with allergen immunotherapy initiation and adherence. J Allergy Clin Immunol 2011; 127 (1): 46–48, 48.e1–3.
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