Abstract: Objective To evaluate the efficacy and compliance of Artemisia annua pollen allergen sublingual immunotherapy(SLIT)in patients with Artemisia pollen-induced allergic rhinitis, and to analyze its effectiveness in monosensitized and multisensitized patients. Methods A single-center controlled study was conducted, enrolling 92 patients with Artemisia pollen-induced allergic rhinitis. Among them, 46 patients receiving sublingual immunotherapy(SLIT)formed the SLIT group, while 46 patients receiving only symptomatic medication served as the control group. Compare the total nasal symptom score(TNSS), total medication score(TMS), combined symptom and medication score(CSMS), and visual analogue scale(VAS)scores between the two patient groups during the pollen peak season before treatment initiation, and at 1 and 2 years post-treatment. Additionally, record the dropout rate. Patients in the SLIT group were further divided into monosensitized and multisensitized subgroups to evaluate differences in treatment efficacy between the two groups. Results At baseline, there were no statistically significant differences between the two groups in age, gender, sensitization status, TNSS, TMS, CSMS, or VAS(P=0.385, P=0.569, P=0.227, P=0.138, P=0.524, P=0.133, P=0.255), indicating comparability. In the SLIT group, Artemisia slgE levels predominantly fell within grades 3, 4, 5, and 6, accounting for 85.2%of Artemisia-sensitized individuals. In the control group, 25 subjects exhibited multiple sensitivities, with Artemisia and ragweed as the primary allergens. Artemisia slgE levels primarily clustered at grades 4 and 5, representing 61.54% of Artemisia-sensitized individuals. In the SLIT group, TNSS, CSMS, and VAS scores during pollen peak seasons in the first and second years post-treatment were significantly lower than baseline values, with statistically significant differences observed within the group(P<0.001). Except for TMS scores, statistically significant differences were found between groups for all scores during pollen peak seasons at 1 and 2 years post-treatment(P<0.01). Results from generalized estimating equations analysis showed statistically significant differences in between-group effects, time effects, and interaction effects for TNSS, CSMS, and VAS scores(P<0.001). Only the time effect for TMS scores was not significant(P>0.05). Among nasal symptoms, intergroup differences in sneezing and rhinorrhea were not statistically significant(P>0.05), but differences in nasal itching and nasal congestion scores were significant(P<0.001). Time effects and interaction effects for all symptoms were significant(P<0.001), indicating statistically significant differences in symptom score changes over time between the two groups. There were no statistically significant differences in pre- treatment symptoms between monosensitized and multisensitized patients in the SLIT group(P=0.940, P=0.667, P=0.188, P=0.806), and no statistically significant differences in treatment efficacy were observed between the two groups at one and two years post-treatment(P=0.737, P=0.9, P=0.384, P=0.607, P=0.476, P=0.498, P=0.876, P=0.696). A total of 19 participants ultimately dropped out: 5 cases(26.32%)were unable to persist; 4cases(21.05%)showed no improvement; 3 cases(15.79%)cited personal or work-related factors; 3 cases(15.79%)attributed to pandemic-related reasons; 2 cases(10.53%)cited high costs; 1 case(5.26%)reported improvement;1 case(5.26%)perceived worsening symptoms. Conclusion This study demonstrates that Artemisia annua pollen allergen sublingual drops exhibit long-term efficacy for allergic rhinitis caused by Artemisia pollen, with comparable therapeutic effects observed in both monosensitized and multisensitized patients. This finding provides important reference for clinical treatment. Future research should focus on multicenter, large- sample, long-follow-up designs, and leverage big data and machine learning technologies to develop efficacy prediction tools, thereby further optimizing treatment regimens.

Key words: Allergic rhinitis, Sublingual immunotherapy, Efficacy, Single sensitization, Multiple sensitization