Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double‐blind, randomized, placebo‐controlled study

Ko, Jiunn‐Liang; Lin, Yung-Hsiang; Sun, Hai-Lun; Lu, Ko-Hsiu; Hsieh, Jie-Cheng; Chou, Ming-Chih

doi:10.1111/j.1399-3038.2006.00443.x

Cited by 108 publications

(96 citation statements)

References 19 publications

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“…In HDM-sensitive children with mild to moderate asthma, it has been demonstrated that SLIT for 6 months was associated with a decrease in asthma symptoms and medication use, as well as with an improvement in lung function [166,167]; however, in children with asthma optimally controlled by pharmacologic treatment and HDM avoidance, SLIT-tablets did not provide additional benefit, despite a significant reduction in allergic response to HDM [168]. Retrospective studies in this pediatric population indicate that HDM-based SLIT significantly reduces the number of acute asthma attacks [169], the duration and dose of ICS [170], and symptomatic medication use [171].…”

Section: Pediatric Populationsmentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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Asthma is frequently associated with atopy, characterized by the production of specific immunoglobulin E in response to environmental allergens. Currently, two types of allergen immunotherapy (AIT) are used in clinical practice: subcutaneous and sublingual immunotherapy, both accepted as key components of the therapeutic repertoire for allergic rhinitis and conjunctivitis. However, their role in asthma remains controversial. The present document is aimed at providing the clinicians with a review of the evidence on the use of AIT in asthma, focusing on the most relevant aspects of its mechanism of action, its efficacy, and existing data on safety, tolerability, and cost-effectivity, both in pediatric and adult populations. A systematic search of MEDLINE, Cochrane, and Clinical Trials databases from 2000 to April of 2016 was carried out by a panel of experts from the Spanish Allergy and Clinical Immunology Scientific Society. Relevant studies prior to the year 2000 included in ulterior systematic reviews were also considered. More than 4000 articles were identified during the search and 241 were selected to retrieve available evidence on AIT, which was graded according to the Oxford classification. All the group members reviewed the resulting text until the final version reached the consensual agreement. A summary of recommendations on the more relevant topics are proposed. The role of AIT as a valuable therapeutic strategy for prevention of exacerbation and progressive decline in lung function is highlighted. Future research should include specific tools for asthma evaluation when assessing AIT effectiveness in asthmatic patients. ResumenEl asma se asocia frecuentemente con alergia, entendida ésta como la producción de IgE específica frente a alérgenos ambientales. Actualmente, existen dos tipos de inmunoterapia específica con alérgenos (ITE) para la práctica clínica habitual: subcutánea y sublingual, ambas indicadas en el tratamiento de la rinitis y la conjuntivitis alérgicas. Sin embargo, su papel en el asma resulta todavía controvertido. Dominguez-Ortega J, et al.

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Section: Pediatric Populationsmentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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“…[22][23][24][25][26][27][28][29]32,33,[35][36][37] Six studies evaluated dust mite allergen. [22][23][24][25][26]32 The placebo-controlled studies demonstrated significant reductions in medication use in the SLIT group relative to the placebo group, with moderate to strong magnitudes of effect in patients with asthma and/or rhinitis. The magnitudes of effect could not be determined in 7 studies.…”

Section: Medication Scoresmentioning

confidence: 99%

“…[22][23][24][32][33][34][35]37,38 Seven studies evaluated dust mite allergen. [22][23][24][32][33][34]38 The SLIT-treated children in the placebo-controlled studies demonstrated moderate to strong improvement in asthma symptoms. The risk of bias was low in 3 studies.…”

Section: Asthmamentioning

confidence: 99%

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Subcutaneous immunotherapy (SCIT) is approved in the United States for the treatment of pediatric asthma and rhinitis; sublingual immunotherapy (SLIT) does not have regulatory approval but is used in clinical practice. The objective of this study was to systematically review the evidence regarding the efficacy and safety of SCIT and SLIT for the treatment of pediatric asthma and allergic rhinoconjunctivitis. METHODS:Two independent reviewers selected articles for inclusion, extracted data, and graded the strength of evidence for each clinical outcome. All studies were randomized controlled trials of children with allergic asthma or rhinoconjunctivitis treated with SCIT or an aqueous formulation of SLIT. Data sources were Medline, Embase, LILACS, CENTRAL, and the Cochrane Central Register of Controlled Trials through May 2012. RESULTS:In 13 trials, 920 children received SCIT or usual care; in 18 studies, 1583 children received SLIT or usual care. Three studies compared SCIT with SLIT head-to-head in 135 children. The strength of evidence is moderate that SCIT improves asthma and rhinitis symptoms and low that SCIT improves conjunctivitis symptoms and asthma medication scores. Strength of evidence is high that SLIT improves asthma symptoms and moderate that SLIT improves rhinitis and conjunctivitis symptoms and decreases medication usage. The evidence is low to support SCIT over SLIT for improving asthma or rhinitis symptoms or medication usage. Local reactions were frequent with SCIT and SLIT. There was 1 report of anaphylaxis with SCIT.CONCLUSIONS: Evidence supports the efficacy of both SCIT and SLIT for the treatment of asthma and rhinitis in children. Pediatrics

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“…On the contrary, other works underlined the capability of SLIT with pollen allergens or with house dust mites to induce an increase of specific IgG4 (36)(37)(38)(39). Despite the lack of unanimous consent regarding the mechanism of action of SLIT, several trials have shown the efficacy of SLIT in improving symptoms in patients with allergic rhinitis and/or bronchial asthma, and with latex allergy.…”

Section: Discussionmentioning

confidence: 99%

Sublingual Desensitization in Patients with Wasp Venom Allergy: Preliminary Results

Patriarca¹,

Nucera²,

Roncallo³

et al. 2008

Int J Immunopathol Pharmacol

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The aim ofthis paper is to assess in an open prospective pilot case-control study the tolerability, safety and efficacy of an ultra-rush sublingual immunotherapy (SLIT) protocol with Vespula venom in wasp allergic patients compared to subcutaneous immunotherapy (SCIT). Forty-one wasp allergic patients were treated with sublingual (SLIT group) or subcutaneous (SCIT group) ultrarush immunotherapy with Vespula venom extract. All patients underwent skin tests and serum specific IgE and IgG 4 detection before enrolment and after 6, 12 and 24 months of immunotherapy. The SLIT group consisted of 21 (6 females and 15 males) patients who received increasing doses of Vespula venom (Aquagen, ALK-AbeIl6) until the final dose of 30 drops of extract in 3 hours, containing 100,000 SQ-U/ml. The maintenance dose was of 10 drops of pure venom extract 3 times a week, for a total dose of 100,000 SQ-U weekly (corresponding to 100 JIg of venom extract). The SCIT group consisted of 20 patients (16 males and 4 females) who were treated with subcutaneous ultrarush immunotherapy with Vespula venom extract (Pharmalgen, Alk-AbeIl6). Patients received 101.1 j..lg of Vespula venom in 3 hours and were treated with 100 ug of wasp venom monthly. During the ultrarush sublingual treatment 2 patients (9.5%) experienced mild side-effects. Specific IgE and specific IgG to wasp venom did not show any significant modification. Four patients were field-stung by a wasp during the treatment (for a total of 6 stings). Two patients (3 stings), with a previous clinical history of a grade III and IV reaction, did not experience any reaction. One patient, with a previous grade II reaction, showed a large local reaction. The fourth patient, with a previous grade III reaction, was re-stung twice (after 12 and 24 months) with two systemic reactions (SR) (mild throat constriction). During the ultrarush SCIT phase, 3 (15%) patients experienced side-effects: 2 of them showed a large local reaction and 1 had headache and stomach ache. Specific IgE showed a significant (P=O.OOI) increase after 6 months of treatment and then returned to baseline levels while specific IgG showed a significant (P=O.OOI) increase after 6, 12 and 24 months in comparison with baseline. Nine patients were field-stung during the treatment: 8 of them experienced large local reactions; one patient (11%) experienced an SR (dizziness). Our results, even if in a small number of patients, suggest that in patients with Hymenoptera sting allergy SLIT could be efficacious with a good tolerability profile when compared to SCIT. Larger studies are needed to assess efficacy, safety and tolerability profile of wasp venom SLIT.

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Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double‐blind, randomized, placebo‐controlled study

Cited by 108 publications

References 19 publications

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Sublingual Desensitization in Patients with Wasp Venom Allergy: Preliminary Results

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