Real-life Adherence and Evidence of Sublingual Immunotherapy in Allergic Rhinitis and Asthma Among Tunisian Active-Duty Service Members

Abstract

<bold>Background:</bold>Deployed military members may be more prone to developing chronic upper respiratory conditions than their non-deployed counterparts, which may be related to exposure to higher levels of air pollution, harsh environments, and foreign dust storms <bold>Aim:</bold>To evaluate the adherence to allergen immunotherapy (AIT) with sublingual immunotherapy (SLIT) in allergic patients. <bold>Methods:</bold>It was a retrospective study, focused on records of patients follow-up for allergic rhinitis(AR) and asthma. Adherence was determined as the accomplishment of 3 years of SLIT. <bold>Results:</bold>110 records were consulted. The average age of patients was 29.2 years.66 patients were men (60%).91 patients(82.7%)were diagnosed as having asthma,78 patients(70.9%) had concomitant AR and asthma and 19 patients(17.2%)had AR,with a median duration of disease 3.4 years. House dust mites were the most important causes of allergic sensitization(93.3%). The median duration of SLIT was 20.7 months(1–60) and a total of 35 patients(31.8%) dropped out of SLIT before 3 years of treatment were completed. The main reasons for discontinuation in patients who dropped out were: undesirable effects 13 cases(11.8%), feeling that treatment was ineffective 9 cases(8.1%), forced discontinuation due to pregnancy 3 cases(2.7%),or improvement 10 cases(9%). Sublingual immunotherapy (SLIT) is associated more with local side effects, but no serious systemic effects were noted, notably no cases of anaphylactic shock, angioedema or moderate or severe asthma attacks. <bold>Conclusion:</bold>Adherence is crucial for AIT efficacy. It still needs to be brought to the attention of healthcare professionals especially in the early stages of treatment.