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Influencing Factors of Efficacy of House Dust Mite SCIT in School-Age Asthmatic Children and Construction of Prediction Model
Received date: 2024-12-25
Revised date: 2025-04-17
Accepted date: 2025-05-08
Online published: 2026-02-11
Objective： To investigate the determinants influencing the efficacy of house dust mite subcutaneous specific immunotherapy （SCIT） in school-age children with asthma and to develop a risk prediction model for clinical reference.Methods： A total of 160 school-age asthmatic children who received standard house dust mite SCIT at our hospital between May 2018 and May 2021 were retrospectively reviewed， of whom 154 completed the 3-year treatment. Based on whether inhaled corticosteroids （ICS） could be completely withdrawn after 3 years， patients were categorized into the ICS withdrawal group （n=99） and the ICS continuation group （n=55）. Clinical data were collected retrospectively. Multivariate logistic regression was used to identify independent factors associated with treatment efficacy and to construct a predictive model. The discriminative ability of the model was evaluated by the area under the receiver operating characteristic （ROC） curve （AUC）.Results： The dosage of fluticasone propionate （FP） gradually decreased in both groups during the treatment， with statistically significant differences between the two groups at 12， 24， and 36 months （P<0.05）. Compared to the ICS continuation group， the ICS withdrawal group had significantly higher proportions of overweight， severe persistent asthma， comorbid allergic rhinitis， multiple allergen sensitizations， and exposure to passive smoking （P<0.05）. Multivariate logistic regression analysis identified severe persistent asthma （OR>1）， multiple allergen sensitizations （OR>1）， and passive smoking exposure （OR>1） as independent risk factors for failure to discontinue ICS after treatment （all P<0.05）. The logistic regression prediction model showed a good fit （P<0.05）. ROC curve analysis revealed an AUC of 0.829 （P<0.05）. At an optimal cut-off value of 0.650， the model demonstrated a sensitivity of 0.707 and a specificity of 0.855 （P<0.05）.Conclusion： Severe persistent asthma， multiple allergen sensitizations， and passive smoking exposure are significant determinants affecting the efficacy of house dust mite SCIT in school-age asthmatic children. The prediction model based on these factors shows acceptable discriminative ability.
jian-guo JING
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Influencing Factors of Efficacy of House Dust Mite
SCIT in School-Age Asthmatic Children and Construction of Prediction Model
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