Short-term improvement in health-related quality of life in adult rhinitis/asthma patients treated with Acaroid®

array:23 ["pii" => "S0301054612002674" "issn" => "03010546" "doi" => "10.1016/j.aller.2012.10.002" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "436" "copyright" => "SEICAP" "copyrightAnyo" => "2012" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Allergol Immunopathol (Madr). 2014;42:169-71" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 717 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 459 "PDF" => 247 ] ] "itemSiguiente" => array:18 [ "pii" => "S0301054612002765" "issn" => "03010546" "doi" => "10.1016/j.aller.2012.09.002" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "445" "copyright" => "SEICAP" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Allergol Immunopathol (Madr). 2014;42:171-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 737 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 487 "PDF" => 244 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Research Letter" "titulo" => "Serum IgE discriminates allergy from sensitisation better than skin testing" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "171" "paginaFinal" => "173" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2266 "Ancho" => 2713 "Tamanyo" => 277115 ] ] "descripcion" => array:1 [ "en" => "(a) Percentage of patients with sensitisation and allergy. (b) Specific IgE distribution (kU/L) evaluated in patients with allergy (causal allergens) or with sensitisation (sensitising allergens) to aeroallergens with skin prick test 4+. Values were represented as medians (black line), quartiles (25th and 75th percentiles, white box), and p-value between the groups. (c) ROC curve and (d) discrimination ability of the chosen cut-off of 9.58kU/L for the specific IgE levels in patients with sensitisation or allergy to aeroallergens with skin prick test 4+." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Roberta Alesina, Mara De Amici, Giorgio Ciprandi" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Roberta" "apellidos" => "Alesina" ] 1 => array:2 [ "nombre" => "Mara" "apellidos" => "De Amici" ] 2 => array:2 [ "nombre" => "Giorgio" "apellidos" => "Ciprandi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612002765?idApp=UINPBA00004N" "url" => "/03010546/0000004200000002/v1_201403270032/S0301054612002765/v1_201403270032/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0301054612002698" "issn" => "03010546" "doi" => "10.1016/j.aller.2012.10.004" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "438" "copyright" => "SEICAP" "documento" => "article" "crossmark" => 0 "subdocumento" => "rev" "cita" => "Allergol Immunopathol (Madr). 2014;42:162-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 835 "formatos" => array:3 [ "EPUB" => 12 "HTML" => 547 "PDF" => 276 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Review" "titulo" => "Baseline management of asthma control" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "162" "paginaFinal" => "168" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "O. Cavkaytar, B.E. Sekerel" "autores" => array:2 [ 0 => array:2 [ "nombre" => "O." "apellidos" => "Cavkaytar" ] 1 => array:2 [ "nombre" => "B.E." "apellidos" => "Sekerel" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612002698?idApp=UINPBA00004N" "url" => "/03010546/0000004200000002/v1_201403270032/S0301054612002698/v1_201403270032/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Research letter" "titulo" => "Short-term improvement in health-related quality of life in adult rhinitis/asthma patients treated with Acaroid®" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "169" "paginaFinal" => "171" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. Cruz Niesvaara, J.A. Cumplido Bonny, H.R. Hernández Suárez, L. Almeida Quintana, T. Carrillo Díaz" "autores" => array:5 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Cruz Niesvaara" ] 1 => array:2 [ "nombre" => "J.A." "apellidos" => "Cumplido Bonny" ] 2 => array:2 [ "nombre" => "H.R." "apellidos" => "Hernández Suárez" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Almeida Quintana" ] 4 => array:4 [ "nombre" => "T." "apellidos" => "Carrillo Díaz" "email" => array:1 [ 0 => "tcardia@gobiernodecanarias.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Allergy Department, Gran Canaria Universitary Hospital Dr. Negrín, Las Palmas de Gran canaria, Canary Islands, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "Determination of efficacy of allergic vaccines, in the context of clinical trial, is mainly based on the objective quantification of medication administered and symptoms evolution with little relevance of variables perceived by patients. IgE-mediated respiratory diseases have an important social and psychological repercussion for patients as well as economic consequences. In this sense, it seems important to record and analyse Patient-Reported Outcomes (PROs) which refers to any report coming from patients about a health condition and its treatment.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> PROs are gaining importance in clinical research because of their relevance in the overall treatment efficacy assessment.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Among PROs, Health Related Quality of Life (HRQoL) has been extensively evaluated in rhinitis and asthma.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Several validated tools have been developed to assess variations in HRQoL in rhinitis and asthma, including both the Rhinoconjunctivitis<a class="elsevierStyleCrossRef" href="#bib0010">2</a> and Asthma<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Quality of Life Questionnaires (RQLQ, AQLQ) developed by Junniper, highlighted by their widespread use.High-dose allergoid immunotherapy (Acaroid®) has demonstrated its clinical effectiveness and safety in several clinical trials,<a class="elsevierStyleCrossRefs" href="#bib0020">4,5</a> for treatment of allergic disease mediated by IgE aetiologically related to house dust mites. The aim of this study was to assess improvements in HRQoL of patients after the first two months of treatment with Acaroid®.The tested product Acaroid® (Allergopharma KG, Reinbek, Germany) is an aluminium hydroxide-adsorbed depot allergoid preparation of standardised (in therapeutic units, TU) high concentrations of powdered diafiltered dust mite allergens modified with formaldehyde and glutaraldehyde. There are two different concentrations, A strength (1000TU/mL), and B strength (10,000TU/mL). Allergens quantified in the last step prior to allergoidisation are 11.66μg/mL Der p 1, and 10μg/mL Der p 2 in the 100% Dermatophagoides pteronyssinus formulation, and 20μg/mL Der f 1 and 15μg/mL Der f 2 in the 100% Dermatophagoides farinae formulation.A retrospective observational study including patients with allergic rhinitis and/or bronchial asthma was performed at the Allergy Service of Doctor Negrin Universitary Hospital (Canary Islands, Spain) between October 2009 and August 2011. Both questionnaires were administered before the beginning of the immunotherapy and eight weeks later. The inclusion criteria were: adult patients between 18 and 65 years old, diagnoses with rhinitis and/or bronchial asthma IgE-mediated by house dust mites and were likely to receive immunotherapy with Acaroid®. All patients accepted participation in the study by signing the informed consent form.The sRQLQ has 28 questions distributed in seven different domains: activity limitation, sleep problems, nose symptoms, eye symptoms, non-nose/eye symptoms, practical problems and emotional function. Patients respond to each question on a 7-point scale (0=not impaired at all–6=severely impaired). The sAQLQ includes 32 questions in four domains: symptoms, activity limitation, emotional function and environmental stimuli. Patients are asked to respond to all questions on a 7-point scale (7=not impaired at all–1=severely impaired). HRQoL was assessed at the beginning of the immunotherapy and eight weeks later. The Spanish validated versions for RQLQ and AQLQ were used in the study.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> Patients with allergic rhinitis and bronchial asthma fulfilled both questionnaires.For both questionnaires, the overall score is the mean of all 28 or 32 responses (sRQLQ and sAQLQ, respectively), and the individual domain scores are the means of the items in those domains. The statistical significance of the differences between HRQoL scores at weeks 0 and 8 was determined using Student's t-test (paired samples, two tails, P<0.05). Previously, the Kolmogorov–Smirnov test and the Bartlett test were used to check both the normality and homoscedasticity of the samples.A total of 48 patients were requested to participate in this study, acceptance percentage was 100%. Baseline characteristics, degree of disease severity according to ARIA (for rhinoconjunctivitis) and GINA (for asthma) and immunotherapy administered are described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. All patients were sensitised to house dust mites, 92% of rhinoconjunctivitis patients and 93% of bronchial asthma patients were monosensitised, respectively. The rest of patients were poli-sensitised, however this sensitisation may not impact on clinical symptoms. 44 (92%) of 48 patients with rhinitis and 19 (63%) of 30 asthmatic patients fulfilled the questionnaires at weeks 0 and 8, respectively. Results reported below refer to this number of patients.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>We observed statistically significant differences in the sRQLQ and sAQLQ overall scores after eight weeks of immunotherapy with Acaroid®. A decrease in sRQLQ overall score of 0.45 points was observed, which represents an improvement of HRQL of 19% (P-value <0.05). When the analysis is performed by domains, these differences were also significant for three of the seven domains assessed: sleep problems, practical problems and nose symptoms.For asthmatic patients, an increase of 0.41 sAQLQ overall score was observed, representing an improvement in HRQL of 8% (P-value <0.05). The improved quality of life was also observed in all domains in the sAQLQ with statistical significance for symptoms and emotional function domains. All these results are summarised in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.Treatment of rhinoconjunctivitis/bronchial asthma IgE-mediated by house dust-mites with Acaroid® shows an important and statistically significant improvement in patients’ HRQoL after eight weeks of immunotherapy (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Powell et al.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> not only reported significant improvements in HRQoL of patients treated with a depot extract of phleum but also concluded that this improvement was higher in patients receiving higher doses of grass majority allergen (20μg phl p 5/doses). In this sense, Alvarez Cuesta et al.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> reported significant improvements using a modified therapeutic extract (allergoid).Despite the small number of bronchial asthma patients included, we consider an important contribution of our study the improvements in HRQoL observed in these patients. In a previous study Ameal et al.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> reported improvements in HRQoL for asthma patients after seven weeks of immunotherapy, although this difference was not statistically significant until the end of the study (19 weeks).Based on our findings and considering previous analyses published, we believe that the results reported in our study could be related with high concentrations of the major allergens of Dermatophagoides that are administered in each dose of Acaroid®.One limitation could be the retrospective and observational design; nevertheless we consider that the assessment of the therapeutic product under real practice conditions could be clinically relevant. Other limitations of our study rely on the small sample size and the short period of follow-up. Nevertheless, it is necessary to highlight the clinical relevance of our findings. Patients perceived effects of the immunotherapy quickly and significantly. Patients’ satisfaction with their therapy is directly related with perceived effectiveness, which could also improve patients’ adherence to treatment. The significant improvement in HRQoL reported by asthmatic patients is also relevant despite their asthma level (100% GINA I).In conclusion, this is the first study reporting significant improvements in HRQoL after a short period of immunotherapy, both the overall score and by domains score. Despite the short period of follow-up, the administration of Acaroid® in patients with IgE-mediated rhinoconjunctivitis and asthma has shown statistically significant improvements in patient's health-related quality of life. Confirmation of these results should be expected considering a higher sample size and a longer period of follow-up.Ethical disclosuresProtection of human and animal subjectsThe authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration.Confidentiality of dataThe authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study.Right to privacy and informed consentThe authors have obtained the informed consent of the patients and/or subjects mentioned in the article. The author for correspondence is in possession of this document." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "xack77067" "titulo" => "Acknowledgement" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">N \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Percentage \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (Mean, SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(SD 9.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender (Female) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosis</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rhinitis-Rhinoconjunctivitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ARIA Classification:</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persistent-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persistent-moderate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intermittent-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Asthma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GINA classification:</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GINA I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Immunotherapy</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% of D.pteronyssinus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mixture of D. pteronyssinus and D. farinae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab474681.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline and clinical characteristics of patients included in the study." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">HRQL scores week 0Mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">HRQL scores week 8Mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Absolute differencesMeans [95% CI] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">P-value<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Relative diff.Means \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rhinoconjunctivitis</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.27 (1.20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.84 (1.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.43 [0.06; 0.80] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0282<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Activity Limitation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.21 (1.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.68 (1.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.53 [−0.10; 1.17] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.1307 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Emotional function \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.46 (1.49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.37 (1.52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.08 [−0.29; 0.46] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.7951 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Eye symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.93 (1.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.56 (1.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 [−0.14; 0.77] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.2554 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.69 (1.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.07 (1.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.62 [0.08; 1.16] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0422<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-nose/eye symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.11 (1.44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.69 (1.34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.42 [−0.03; 0.86] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0861 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Practical problems \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.96 (1.68) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.37 (1.72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.59 [0.06; 1.13] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0398<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sleep problems \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.79 (1.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.19 (1.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.56 [0.17; 0.95] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0100<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Asthma</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.23 (0.93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.64 (0.80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.41 [0.08; 0.74] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0257<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Activity Limitation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.01 (0.81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.26 (0.78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.26 [−0.05; 0.57] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n 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Rondon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2005.00862.x" "Revista" => array:6 [ "tituloSerie" => "Allergy" "fecha" => "2005" "volumen" => "60" "paginaInicial" => "1178" "paginaFinal" => "1183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16076305" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack77067" "titulo" => "Acknowledgement" "texto" => "This research was funded by the Allergy Department of the Hospital Universitario Dr. Negrín of Las Palmas de Gran Canaria, Spain." ] ] ] "idiomaDefecto" => "en" "url" => "/03010546/0000004200000002/v1_201403270032/S0301054612002674/v1_201403270032/en/main.assets" "Apartado" => array:4 [ "identificador" => "5550" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Research letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03010546/0000004200000002/v1_201403270032/S0301054612002674/v1_201403270032/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612002674?idApp=UINPBA00004N"]

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D. Cruz Niesvaara, J.A. Cumplido Bonny, H.R. Hernández Suárez, L. Almeida Quintana, T. Carrillo Díaz

Corresponding author

tcardia@gobiernodecanarias.org

Corresponding author.

Allergy Department, Gran Canaria Universitary Hospital Dr. Negrín, Las Palmas de Gran canaria, Canary Islands, Spain

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    "titulo" => "Short-term improvement in health-related quality of life in adult rhinitis&#47;asthma patients treated with Acaroid<span class="elsevierStyleSup">&#174;</span>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Determination of efficacy of allergic vaccines&#44; in the context of clinical trial&#44; is mainly based on the objective quantification of medication administered and symptoms evolution with little relevance of variables perceived by patients&#46; IgE-mediated respiratory diseases have an important social and psychological repercussion for patients as well as economic consequences&#46; In this sense&#44; it seems important to record and analyse Patient-Reported Outcomes &#40;PROs&#41; which refers to any report coming from patients about a health condition and its treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> PROs are gaining importance in clinical research because of their relevance in the overall treatment efficacy assessment&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Among PROs&#44; Health Related Quality of Life &#40;HRQoL&#41; has been extensively evaluated in rhinitis and asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Several validated tools have been developed to assess variations in HRQoL in rhinitis and asthma&#44; including both the Rhinoconjunctivitis<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and Asthma<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Quality of Life Questionnaires &#40;RQLQ&#44; AQLQ&#41; developed by Junniper&#44; highlighted by their widespread use&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">High-dose allergoid immunotherapy &#40;Acaroid<span class="elsevierStyleSup">&#174;</span>&#41; has demonstrated its clinical effectiveness and safety in several clinical trials&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> for treatment of allergic disease mediated by IgE aetiologically related to house dust mites&#46; The aim of this study was to assess improvements in HRQoL of patients after the first two months of treatment with Acaroid<span class="elsevierStyleSup">&#174;</span>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The tested product Acaroid<span class="elsevierStyleSup">&#174;</span> &#40;Allergopharma KG&#44; Reinbek&#44; Germany&#41; is an aluminium hydroxide-adsorbed depot allergoid preparation of standardised &#40;in therapeutic units&#44; TU&#41; high concentrations of powdered diafiltered dust mite allergens modified with formaldehyde and glutaraldehyde&#46; There are two different concentrations&#44; A strength &#40;1000<span class="elsevierStyleHsp" style=""></span>TU&#47;mL&#41;&#44; and B strength &#40;10&#44;000<span class="elsevierStyleHsp" style=""></span>TU&#47;mL&#41;&#46; Allergens quantified in the last step prior to allergoidisation are 11&#46;66<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL Der p 1&#44; and 10<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL Der p 2 in the 100&#37; <span class="elsevierStyleItalic">Dermatophagoides pteronyssinus</span> formulation&#44; and 20<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL Der f 1 and 15<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL Der f 2 in the 100&#37; <span class="elsevierStyleItalic">Dermatophagoides farinae</span> formulation&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A retrospective observational study including patients with allergic rhinitis and&#47;or bronchial asthma was performed at the Allergy Service of Doctor Negrin Universitary Hospital &#40;Canary Islands&#44; Spain&#41; between October 2009 and August 2011&#46; Both questionnaires were administered before the beginning of the immunotherapy and eight weeks later&#46; The inclusion criteria were&#58; adult patients between 18 and 65 years old&#44; diagnoses with rhinitis and&#47;or bronchial asthma IgE-mediated by house dust mites and were likely to receive immunotherapy with Acaroid<span class="elsevierStyleSup">&#174;</span>&#46; All patients accepted participation in the study by signing the informed consent form&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The sRQLQ has 28 questions distributed in seven different domains&#58; activity limitation&#44; sleep problems&#44; nose symptoms&#44; eye symptoms&#44; non-nose&#47;eye symptoms&#44; practical problems and emotional function&#46; Patients respond to each question on a 7-point scale &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>not impaired at all&#8211;6<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>severely impaired&#41;&#46; The sAQLQ includes 32 questions in four domains&#58; symptoms&#44; activity limitation&#44; emotional function and environmental stimuli&#46; Patients are asked to respond to all questions on a 7-point scale &#40;7<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>not impaired at all&#8211;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>severely impaired&#41;&#46; HRQoL was assessed at the beginning of the immunotherapy and eight weeks later&#46; The Spanish validated versions for RQLQ and AQLQ were used in the study&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Patients with allergic rhinitis and bronchial asthma fulfilled both questionnaires&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">For both questionnaires&#44; the overall score is the mean of all 28 or 32 responses &#40;sRQLQ and sAQLQ&#44; respectively&#41;&#44; and the individual domain scores are the means of the items in those domains&#46; The statistical significance of the differences between HRQoL scores at weeks 0 and 8 was determined using Student&#39;s <span class="elsevierStyleItalic">t</span>-test &#40;paired samples&#44; two tails&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Previously&#44; the Kolmogorov&#8211;Smirnov test and the Bartlett test were used to check both the normality and homoscedasticity of the samples&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 48 patients were requested to participate in this study&#44; acceptance percentage was 100&#37;&#46; Baseline characteristics&#44; degree of disease severity according to ARIA &#40;for rhinoconjunctivitis&#41; and GINA &#40;for asthma&#41; and immunotherapy administered are described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; All patients were sensitised to house dust mites&#44; 92&#37; of rhinoconjunctivitis patients and 93&#37; of bronchial asthma patients were monosensitised&#44; respectively&#46; The rest of patients were poli-sensitised&#44; however this sensitisation may not impact on clinical symptoms&#46; 44 &#40;92&#37;&#41; of 48 patients with rhinitis and 19 &#40;63&#37;&#41; of 30 asthmatic patients fulfilled the questionnaires at weeks 0 and 8&#44; respectively&#46; Results reported below refer to this number of patients&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">We observed statistically significant differences in the sRQLQ and sAQLQ overall scores after eight weeks of immunotherapy with Acaroid<span class="elsevierStyleSup">&#174;</span>&#46; A decrease in sRQLQ overall score of 0&#46;45 points was observed&#44; which represents an improvement of HRQL of 19&#37; &#40;<span class="elsevierStyleItalic">P</span>-value &#60;0&#46;05&#41;&#46; When the analysis is performed by domains&#44; these differences were also significant for three of the seven domains assessed&#58; sleep problems&#44; practical problems and nose symptoms&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">For asthmatic patients&#44; an increase of 0&#46;41 sAQLQ overall score was observed&#44; representing an improvement in HRQL of 8&#37; &#40;<span class="elsevierStyleItalic">P</span>-value &#60;0&#46;05&#41;&#46; The improved quality of life was also observed in all domains in the sAQLQ with statistical significance for symptoms and emotional function domains&#46; All these results are summarised in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Treatment of rhinoconjunctivitis&#47;bronchial asthma IgE-mediated by house dust-mites with Acaroid<span class="elsevierStyleSup">&#174;</span> shows an important and statistically significant improvement in patients&#8217; HRQoL after eight weeks of immunotherapy &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Powell et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> not only reported significant improvements in HRQoL of patients treated with a depot extract of phleum but also concluded that this improvement was higher in patients receiving higher doses of grass majority allergen &#40;20<span class="elsevierStyleHsp" style=""></span>&#956;g phl p 5&#47;doses&#41;&#46; In this sense&#44; Alvarez Cuesta et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> reported significant improvements using a modified therapeutic extract &#40;allergoid&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Despite the small number of bronchial asthma patients included&#44; we consider an important contribution of our study the improvements in HRQoL observed in these patients&#46; In a previous study Ameal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> reported improvements in HRQoL for asthma patients after seven weeks of immunotherapy&#44; although this difference was not statistically significant until the end of the study &#40;19 weeks&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Based on our findings and considering previous analyses published&#44; we believe that the results reported in our study could be related with high concentrations of the major allergens of <span class="elsevierStyleItalic">Dermatophagoides</span> that are administered in each dose of Acaroid<span class="elsevierStyleSup">&#174;</span>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">One limitation could be the retrospective and observational design&#59; nevertheless we consider that the assessment of the therapeutic product under real practice conditions could be clinically relevant&#46; Other limitations of our study rely on the small sample size and the short period of follow-up&#46; Nevertheless&#44; it is necessary to highlight the clinical relevance of our findings&#46; Patients perceived effects of the immunotherapy quickly and significantly&#46; Patients&#8217; satisfaction with their therapy is directly related with perceived effectiveness&#44; which could also improve patients&#8217; adherence to treatment&#46; The significant improvement in HRQoL reported by asthmatic patients is also relevant despite their asthma level &#40;100&#37; GINA I&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In conclusion&#44; this is the first study reporting significant improvements in HRQoL after a short period of immunotherapy&#44; both the overall score and by domains score&#46; Despite the short period of follow-up&#44; the administration of Acaroid<span class="elsevierStyleSup">&#174;</span> in patients with IgE-mediated rhinoconjunctivitis and asthma has shown statistically significant improvements in patient&#39;s health-related quality of life&#46; Confirmation of these results should be expected considering a higher sample size and a longer period of follow-up&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protection of human and animal subjects</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidentiality of data</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Right to privacy and informed consent</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of the patients and&#47;or subjects mentioned in the article&#46; The author for correspondence is in possession of this document&#46;</p></span></span></span>"
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Asthma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>GINA classification&#58;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>GINA I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Immunotherapy</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">100&#37; of D&#46;pteronyssinus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Mixture of D&#46; pteronyssinus</span> and <span class="elsevierStyleItalic">D&#46; farinae</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">HRQL scores week 0Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">HRQL scores week 8Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Absolute differencesMeans &#91;95&#37; CI&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Relative diff&#46;Means&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Rhinoconjunctivitis</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;27 &#40;1&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;84 &#40;1&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;43 &#91;0&#46;06&#59; 0&#46;80&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0282<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Activity Limitation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;21 &#40;1&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;68 &#40;1&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;53 &#91;&#8722;0&#46;10&#59; 1&#46;17&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Emotional function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;46 &#40;1&#46;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;37 &#40;1&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;08 &#91;&#8722;0&#46;29&#59; 0&#46;46&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;7951&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Eye symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;93 &#40;1&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;56 &#40;1&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;32 &#91;&#8722;0&#46;14&#59; 0&#46;77&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;2554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nasal symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;69 &#40;1&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;07 &#40;1&#46;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;62 &#91;0&#46;08&#59; 1&#46;16&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0422<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-nose&#47;eye symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;11 &#40;1&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;69 &#40;1&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;42 &#91;&#8722;0&#46;03&#59; 0&#46;86&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0861&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Practical problems&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;96 &#40;1&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;37 &#40;1&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;59 &#91;0&#46;06&#59; 1&#46;13&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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Article information

ISSN: 03010546
Original language: English

DOI:10.1016/j.aller.2012.10.002

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	4	0	4
2024 October	18	2	20
2024 September	31	6	37
2024 August	31	2	33
2024 July	20	5	25
2024 June	18	4	22
2024 May	17	6	23
2024 April	20	13	33
2024 March	35	3	38
2024 February	50	4	54
2024 January	40	6	46
2023 December	37	6	43
2023 November	33	5	38
2023 October	50	9	59
2023 September	23	5	28
2023 August	34	7	41
2023 July	30	6	36
2023 June	46	7	53
2023 May	59	3	62
2023 April	61	5	66
2023 March	37	3	40
2023 February	20	7	27
2023 January	14	9	23
2022 December	14	3	17
2022 November	19	6	25
2022 October	19	15	34
2022 September	25	16	41
2022 August	13	9	22
2022 July	20	7	27
2022 June	11	6	17
2022 May	10	10	20
2022 April	19	7	26
2022 March	17	12	29
2022 February	16	6	22
2022 January	24	7	31
2021 December	17	8	25
2021 November	25	11	36
2021 October	18	13	31
2021 September	23	15	38
2021 August	12	9	21
2021 July	12	13	25
2021 June	11	8	19
2021 May	13	5	18
2021 April	34	9	43
2021 March	12	12	24
2021 February	8	24	32
2021 January	11	15	26
2020 December	0	3	3
2020 November	0	2	2
2020 October	0	1	1
2020 September	0	2	2
2020 August	0	2	2
2020 July	0	2	2
2020 June	0	1	1
2020 May	0	4	4
2020 April	0	1	1
2020 March	0	1	1
2020 February	0	3	3
2020 January	0	4	4
2019 December	0	1	1
2019 November	0	2	2
2019 October	0	3	3
2019 September	0	1	1
2019 July	0	9	9
2019 May	0	12	12
2018 February	4	1	5
2018 January	6	1	7
2017 December	4	1	5
2017 November	10	3	13
2017 October	8	5	13
2017 September	8	4	12
2017 August	18	6	24
2017 July	12	1	13
2017 June	14	11	25
2017 May	23	3	26
2017 April	23	8	31
2017 March	18	3	21
2017 February	19	13	32
2017 January	14	0	14
2016 December	15	5	20
2016 November	12	2	14
2016 October	28	7	35
2016 September	12	8	20
2016 August	15	8	23
2016 July	8	1	9
2016 June	19	6	25
2016 May	13	10	23
2016 April	8	13	21
2016 March	12	12	24
2016 February	12	10	22
2016 January	13	12	25
2015 December	14	10	24
2015 November	15	3	18
2015 October	15	10	25
2015 September	9	7	16
2015 August	8	6	14
2015 July	10	6	16
2015 June	4	1	5
2015 May	5	2	7
2015 April	8	4	12
2015 March	17	6	23
2015 February	1	1	2
2015 January	2	0	2
2014 December	2	0	2
2014 October	0	1	1
2014 September	1	0	1
2014 April	0	2	2

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Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon Publications

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Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon Publications

Indexed in:

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