Is immunotherapy protective against steroid intake in patients with polysensitized allergic rhinitis and/or asthma?

Introduction:
The backdrop of this investigation includes concerns about initiating allergen-specific immunotherapy in patients who are polysensitized as well as the impact of allergen immunotherapy on steroid use.

Aim:
To shed light on the protective effects of immunotherapy against steroid intake in polysensitized patients and to eliminate hesitations about starting immunotherapy.

Material and methods:
Between 2018 and 2021, patient records that were already in existence as well as a survey study were used to assess a total of 150 age- and gender-matched patients with rhinitis and/or asthma who were either mono- or polysensitized and had been undergoing immunotherapy for at least 2 years. The possible effects of subcutaneous immunotherapy (SCIT) on the use of oral, nasal and/or inhaled corticosteroids (ICS) were investigated at least 2 years after the immunotherapy began.

Results:
Serum total IgE (t-IgE) and eosinophil levels did not change significantly after SCIT. Although SCIT caused a significant decrease in medication and symptom scores in both the monosensitized group and the polysensitized group, the difference between both groups was not significant. A decrease in intranasal corticosteroid (INS) and ICS doses and usage rates due to SCIT was also observed.

Conclusions:
The effect of SCIT can be seen in both symptom and medication scores. SCIT also reduced both groups’ use of INS and ICS. SCIT also had a strong steroid-sparing effect. Nevertheless, further research into the steroid-sparing effect of SCIT in polysensitized patients is required.