BACKGROUND Most patients with allergic rhinitis are polysensitized. The efficacy of house dust mite (HDM) allergen immunotherapy (AIT) compared between monosensitized and polysensitized patients remains limited. OBJECTIVE To systematically review the efficacy and safety of HDM AIT compared between monosensitized and polysensitized patients with allergic rhinitis. METHODS We searched PubMed/MEDLINE, Scopus, EMBASE, and the Cochrane central register of Controlled Trials (CENTRAL) until June 2022. The primary outcome was the changes from baseline in total nasal symptom score (TNSS). Secondary outcomes were changes from baseline in total medication score (TMS), combined symptom medication score (CSMS), visual analog scale (VAS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, immunological parameters, and adverse events (AEs). RESULTS Of 13 eligible studies, 10 prospective cohorts, 2 retrospective cohorts, and 1 matched cohort, we identified 10 studies for quantitative synthesis. There were 1,113 patients with allergic rhinitis, 566 with HDM monosensitization and 547 with polysensitization to HDM and other allergens. There was no significant difference in the pooled mean changes of the 2 groups in TNSS (SMD -0.05, 95%CI: -0.22 to 0.11, p = 0.532) and VAS (SMD -0.20, 95%CI: -0.42 to 0.01, p = 0.060) with moderate certainty of evidence. The changes in TMS, CSMS, and RQLQ were similar between the 2 groups with very low certainty of evidence. The AEs were mild and comparable between the 2 groups. The immunological indices remained inconsistent and were not predictive of clinical responses. CONCLUSIONS A single HDM AIT similarly improved clinical outcomes in monosensitized and polysensitized patients with allergic rhinitis.

中文翻译：

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过敏性鼻炎单敏与多敏患者的屋尘螨过敏原免疫疗法：系统评价和荟萃分析。

背景大多数变应性鼻炎患者是多敏化的。屋尘螨 (HDM) 过敏原免疫疗法 (AIT) 在单敏和多敏患者之间的疗效比较仍然有限。目的 系统评价 HDM AIT 在过敏性鼻炎单敏和多敏患者之间的疗效和安全性比较。方法 我们搜索了截至 2022 年 6 月的 PubMed/MEDLINE、Scopus、EMBASE 和 Cochrane 对照试验中心登记册 (CENTRAL)。主要结果是总鼻部症状评分 (TNSS) 相对于基线的变化。次要结果是总药物评分 (TMS)、综合症状药物评分 (CSMS)、视觉模拟量表 (VAS)、鼻结膜炎生活质量问卷 (RQLQ) 评分、免疫学参数和不良事件 (AE) 相对于基线的变化。结果 在 13 项符合条件的研究、10 项前瞻性队列、2 项回顾性队列和 1 项匹配队列中，我们确定了 10 项研究进行定量综合。有 1,113 名变应性鼻炎患者，566 名患者对 HDM 单敏化，547 名患者对 HDM 和其他过敏原多敏化。两组在 TNSS（SMD -0.05，95%CI：-0.22 至 0.11，p = 0.532）和 VAS（SMD -0.20，95%CI：-0.42 至 0.01， p = 0.060)，证据质量中等。两组间 TMS、CSMS 和 RQLQ 的变化相似，证据质量非常低。AE 轻微且两组之间具有可比性。免疫指标仍然不一致，不能预测临床反应。