Paediatric Asthma and Allergic Rhinitis: Is Subcutaneous Immunotherapy Safe and Effective? - European Medical Journal

Paediatric Asthma and Allergic Rhinitis: Is Subcutaneous Immunotherapy Safe and Effective?

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TREATING paediatric asthma and allergic rhinitis with subcutaneous combined immunotherapy (SCIT) is safe and improves symptoms, according to new study findings.

A team of researchers from Ege University Faculty of Medicine, İzmir, Turkey, performed a retrospective analysis of 344 patients aged ≤18 years of age, who received SCIT between 2005 and 2021 for a diagnosis of asthma and/or allergic rhinitis, with the aim of evaluating the safety and efficacy of SCIT by determining adverse event incidence and risk factors.

Of the 344 patients, 57.8% were <12 years of age, 40.1% were mono-sensitised, and mean age was 133.1±41.0 months. In terms of diagnoses, 60.2% had allergic rhinitis, 13.7% had asthma, and 26.2% had asthma and allergic rhinitis. Over 33,000 SCIT injections were administered during the study period. In 54.4% of candidates, single allergen content was administered, whilst 45.6% received multiple allergen content administration.

A total of 840 adverse reactions occurred amongst 195 candidates; 68.8% of which occurred at maintenance and 31.1% occurred during the up-dosing phase. Out of the 840 adverse reactions 5.7% were systemic, 75.2% were local, and 19% were large local. No fatalities were reported. The incidence of adverse reactions was found to be higher in those who received SCIT including pollen content, calcium-phosphate as an adjuvant, and those sensitised with mite and grass pollen.

Adverse reactions, particularly local reactions, occurred most frequently in patients ≤12 years of age (p=<0.001). Using univariate analysis, the researchers identified that local reactions were risk factors for large local reactions (odds ratio [OR]: 3.591; 95% confidence interval [CI]: 2.064–6.247; p=<0.001) and systemic reactions (OR: 2.190; 95% CI: 1.005–4.722; p=0.046).

Following 1-year of treatment, the team identified that symptoms improved as measured by Visual Analog Scale, asthma symptom control test scores, and total nasal symptom scores (p=<0.010).

The study authors stated that their findings highlight how SCIT is “a safe treatment method, especially in children under 12 years of age” and effective in treating both conditions. They concluded that paediatric patients with a diagnosis of asthma and/or allergic rhinitis “should be evaluated for early initiation of SCIT as soon as possible”. However, further research/investigation is required as this study was limited by single-centre design and data gaps.



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