Sublingual immunotherapy in the treatment of allergic asthma: a systematic review with meta-analysis

Introduction: The guidelines for the management of allergic respiratory diseases oriented towards control from medical treatment combined with measures of environmental hygiene. Immunotherapy is one of several types of treatment, applied in combination with prophylactic drugs and environmental care. The aim of the study is to evaluate the efficacy of sublingual immunotherapy (SLIT) for house dust mites (HDM) in people with allergic asthma.Methods: The study is based on a systematic review with meta-analysis of randomized clinical trials, associating sublingual immunotherapy with the treatment of allergic patients with HDM.Results: The searches were applied in PubMed, ScienceDirect and Scielo databases. Initially, 98 articles were recovered, of which only nine were eligible. Of these, eight (88.9%) were conducted in Europe and only one (11.1%) in Asia. Comparing the outcomes expiratory volume in the first minute (FEV1) and sensitivity to allergens (HDM) between SLIT and placebo groups before and after intervention, no differences were observed between the groups.Conclusions: SLIT is not evidenced significantly by meta-analysis for the treatment of allergic asthma.Keywords: Mites; asthma; rhinitis; respiratory diseas

Sublingual immunotherapy in the treatment of allergic asthma: a systematic review with meta-analysis

Introduction: The guidelines for the management of allergic respiratory diseases oriented towards control from medical treatment combined with measures of environmental hygiene. Immunotherapy is one of several types of treatment, applied in combination with prophylactic drugs and environmental care. The aim of the study is to evaluate the efficacy of sublingual immunotherapy (SLIT) for house dust mites (HDM) in people with allergic asthma.Methods: The study is based on a systematic review with meta-analysis of randomized clinical trials, associating sublingual immunotherapy with the treatment of allergic patients with HDM.Results: The searches were applied in PubMed, ScienceDirect and Scielo databases. Initially, 98 articles were recovered, of which only nine were eligible. Of these, eight (88.9%) were conducted in Europe and only one (11.1%) in Asia. Comparing the outcomes expiratory volume in the first minute (FEV1) and sensitivity to allergens (HDM) between SLIT and placebo groups before and after intervention, no differences were observed between the groups.Conclusions: SLIT is not evidenced significantly by meta-analysis for the treatment of allergic asthma.Keywords: Mites; asthma; rhinitis; respiratory diseas

SUBLINGUAL IMMUNOTHERAPY IN THE TREATMENT OF ALLERGIC ASTHMA: A SYSTEMATIC REVIEW WITH META-ANALYSIS

Introduction: The guidelines for the management of allergic respiratory diseases oriented towards control from medical treatment combined with measures of environmental hygiene. Immunotherapy is one of several types of treatment, applied in combination with prophylactic drugs and environmental care. The aim of the study is to evaluate the efficacy of sublingual immunotherapy (SLIT) for house dust mites (HDM) in people with allergic asthma. Methods: The study is based on a systematic review with meta-analysis of randomized clinical trials, associating sublingual immunotherapy with the treatment of allergic patients with HDM. Results: The searches were applied in PubMed, ScienceDirect and Scielo databases. Initially, 98 articles were recovered, of which only nine were eligible. Of these, eight (88.9%) were conducted in Europe and only one (11.1%) in Asia. Comparing the outcomes expiratory volume in the first minute (FEV1) and sensitivity to allergens (HDM) between SLIT and placebo groups before and after intervention, no differences were observed between the groups. Conclusions: SLIT is not evidenced significantly by meta-analysis for the treatment of allergic asthma. Keywords: Mites; asthma; rhinitis; respiratory diseas

Skin test in allergic diseases: a systematic review

Aims: To identify the major allergens used in skin tests for atopic sensitization in patients with asthma and allergic rhinitis. Methods: A systematic review was performed to identify clinical studies in the past 10 years whose outcomes included the skin test (prick test) in the diagnosis of asthma and allergic rhinitis. The PubMed, SciELO, and ScienceDirect databases were searched and articles that addressed the direct use of skin testing in the diagnosis of allergic diseases were included. In addition, the studies had to describe the protocol and the allergens used in the test. For selection of the articles, three researchers independently analyzed the inclusion criteria, which were analyzed by two other reviewers. Results: Thirteen instruments were included in the systematic review, and the amount of reagents used varied significantly (between 3 and 36). Of the 36 reagents, five had the highest frequency of positive sensitization (Artemisia vulgaris, Dermatophagoides farinae, Dermatophagoides pteronyssinus, dog and cat epithelia). As part of the application protocol, the forearm and the period of 15-20 minutes are the most frequently used. Conclusions: The most frequently detected allergens were described, and both the region and the studied population are important factors to be considered

Características psicométricas do Questionário Newcastle de conhecimento em asma (NAKQ) para pais de crianças com asma

*** Psychometric characteristics of the Newcastle Asthma Knowledge Questionnaire (NAKQ) for parents of children with asthma ***AIMS: To analyze the psychometric characteristics identified by the Newcastle Asthma Knowledge Questionnaire (NAKQ) in parents of children with asthma.METHODS: Parents of children with asthma were recruited in outpatient follow-up with pediatric pulmonologists. Parents of children with no asthma diagnosis were recruited from public schools in the same city. The NAKQ has 31 items, being 25 questions with answers "true" or "false", and six open questions. The minimum score for knowledge is of 0 (zero) points with a maximum score of 31 points. In addition, the questionnaire is given a cutting point ≥ 21 points to satisfactory levels (suitable) and 21 for unsatisfactory levels < (inappropriate). For the analysis of precision of the instrument, we adopted three criteria: a) internal consistency through the alpha Cronbach (αC) coefficient; b) intraclass correlation coefficient (ICC); and b) test-retest using the Kappa coefficient. For the questionnaire validation, we analyzed the current validity criteria.RESULTS: One hundred and fifty four parents participated in this study, with 62 (40.3%) children with asthma and 92 (59.7%) without asthma, with a mean of 35.6±10.03 years and 132 (85.7%) females. High school was the most prevalent education level (n=72; 46.8%). The αC coefficient was 0.72 and 0.70, for the group of parents of asthmatics and of non-asthmatic children, respectively. The ICC was 0.703 (CI95%: 0.042-0.111) for parents of asthmatics and 0.687 (CI95%: 0.588-0.772) for parents of non-asthmatic. The degree of consistency in responses to each item on the repeated questionnaires, with application of the Kappa index, obtained acceptable values in 25 (80.65%), with eight issues (25.81%) classified as "good" and 17 (54.84%) as "very good".CONCLUSIONS: The NAKQ presented good internal consistency and repeatability indices, showing to be a precise and valid tool for measuring the level of knowledge about the disease in parents of Brazilian children with asthma.*** Características psicométricas do Questionário Newcastle de conhecimento em asma (NAKQ) para pais de crianças com asma ***OBJETIVOS: Analisar as características psicométricas identificadas pelo questionário de conhecimento em asma Newcastle Asthma Knowledge Questionnaire (NAKQ) em pais de crianças com asma.MÉTODOS: Foram recrutados pais de crianças com asma em acompanhamento ambulatorial com pneumologistas pediátricos. Pais de crianças sem diagnóstico de asma foram recrutados em escolas públicas da mesma cidade. O questionário NAKQ possui 31 itens, sendo 25 questões com respostas "verdadeiro" ou "falso", e seis questões abertas. A pontuação mínima de conhecimento é de 0 (zero) pontos e a pontuação máxima é de 31 pontos. Além disso, o questionário recebe um ponto de corte ≥21 pontos para níveis satisfatórios (adequado) e <21 para níveis insatisfatórios (inadequado). Para a análise de precisão do instrumento foram adotados três critérios: a) consistência interna por meio do coeficiente alfa de Cronbach (αC); b) coeficiente de correlação intraclasse (CCI); e b) teste-reteste por meio do coeficiente Kappa. Para a validação foi analisado o critério de validade corrente.RESULTADOS: Cento e cinquenta e quatro pais participaram do estudo, sendo 62 (40,3%) do grupo de asmáticos e 92 (59,7%) do grupo controle, com média de idade 35,6±10,03 anos, sendo 132 (85,7%) do sexo feminino. O ensino médio completo foi a escolaridade mais prevalente (n=72; 46,8%). O coeficiente αC foi de 0,72 e 0,70, para os grupos de pais de asmáticos e pais de crianças não asmáticas, respectivamente. O CCI foi de 0,703 (IC95%: 0,042-0,111) para pais de asmáticos e 0,687 (IC95%: 0,588-0,772) para pais de crianças sem asma. O grau de consistência nas respostas para cada item sobre a administração repetida do questionário, com aplicação do índice de Kappa, obteve valores aceitáveis em 25 (80,65%) questões, sendo oito (25,81%) classificadas como "boa" e 17 (54,84%) como "muito boa".CONCLUSÕES: O NAKQ apresentou bons índices de consistência interna e reprodutibilidade, demostrando ser um instrumento preciso e válido para mensurar o nível de conhecimento sobre a doença em pais de crianças brasileiras com asma

Características psicométricas do questionário newcastle de conhecimento em asma (NAKQ) para pais de crianças com asma = Psychometric characteristics of the newcastle asthma knowledge questionnaire (NAKQ) for parents of children with asthma

OBJETIVOS: Analisar as características psicométricas identificadas pelo questionário de conhecimento em asma Newcastle Asthma Knowledge Questionnaire (NAKQ) em pais de crianças com asma. MÉTODOS: Foram recrutados pais de crianças com asma em acompanhamento ambulatorial com pneumologistas pediátricos. Pais de crianças sem diagnóstico de asma foram recrutados em escolas públicas da mesma cidade. O questionário NAKQ possui 31 itens, sendo 25 questões com respostas “verdadeiro” ou “falso”, e seis questões abertas. A pontuação mínima de conhecimento é de 0 (zero) pontos e a pontuação máxima é de 31 pontos. Além disso, o questionário recebe um ponto de corte ≥21 pontos para níveis satisfatórios (adequado) e <21 para níveis insatisfatórios (inadequado). Para a análise de precisão do instrumento foram adotados três critérios: a) consistência interna por meio do coeficiente alfa de Cronbach (αC); b) coeficiente de correlação intraclasse (CCI); e b) teste-reteste por meio do coeficiente Kappa. Para a validação foi analisado o critério de validade corrente. RESULTADOS: Cento e cinquenta e quatro pais participaram do estudo, sendo 62 (40,3%) do grupo de asmáticos e 92 (59,7%) do grupo controle, com média de idade 35,6±10,03 anos, sendo 132 (85,7%) do sexo feminino. O ensino médio completo foi a escolaridade mais prevalente (n=72; 46,8%). O coeficiente αC foi de 0,72 e 0,70, para os grupos de pais de asmáticos e pais de crianças não asmáticas, respectivamente. O CCI foi de 0,703 (IC95%: 0,042-0,111) para pais de asmáticos e 0,687 (IC95%: 0,588-0,772) para pais de crianças sem asma. O grau de consistência nas respostas para cada item sobre a administração repetida do questionário, com aplicação do índice de Kappa, obteve valores aceitáveis em 25 (80,65%) questões, sendo oito (25,81%) classificadas como “boa” e 17 (54,84%) como “muito boa” CONCLUSÕES: O NAKQ apresentou bons índices de consistência interna e reprodutibilidade, demostrando ser um instrumento preciso e válido para mensurar o nível de conhecimento sobre a doença em pais de crianças brasileiras com asm

Levels of knowledge about asthma of parents of asthmatic children

<div><p>ABSTRACT Objective To evaluate the levels of knowledge about asthma of parents of school children. Methods A cross-sectional study was carried out with parents of children with medical diagnosis of asthma (mild, moderate and severe), followed up at an outpatient referral center for childhood asthma in the Southern region of Brazil (Asthma Group). Parents of children with asthma in remission and healthy children were also selected (Control Group). The Newcastle Asthma Knowledge Questionnaire (NAKQ) questionnaire was applied in both groups. Results A total of 154 parents of children participated in the study; in that, 62 (40.26%) in the Asthma Group, and 92 (59.74%) in the Control Group, with a mean age of 35.60±10.03 years. Of these, 132 (85.7%) were female, and 72 (46.8%) parents studied up to high school. The average score of level of knowledge was 18.06±4.11 points. Only 30.5% parents had acceptable levels of knowledge about asthma, which were more prevalent in the Asthma Group than in the Control Group (41.9% versus 22.8%, p=0.01). The mean score in Newcastle Asthma Knowledge Questionnaire (NAKQ) was higher in the Asthma Group (19.32±3.92 versus 17.21±4.03, p=0.001), respectively. The parents with mild and moderate asthmatic children scored more than those of severe asthma (19.5 and 19.9 versus 18.2 points, p=0.02). Conclusion Most parents had an unsatisfactory level of knowledge about asthma, which reinforces the need for changes in public asthma management programs.</p></div