Efficacy of high-dose sublingual immunotherapy in children allergic to house dust mites in real-life clinical practice

Ferres, J.; Justicia, José L; García, Mª Pilar Sánchez; Muñoz-Tudurí, M.; Alvà, Víctor

doi:10.1016/j.aller.2010.01.008

Cited by 26 publications

(23 citation statements)

References 23 publications

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“…In our cohort, both children and adults were included, and 52.3% had coexistent asthma. This prevalence, although greater than that seen in randomized studies on AR, is comparable with that seen in other real-life observational studies 17,21–23. Prior to treatment initiation, we found that majority of the patients suffered a wide range of symptoms during the previous olive pollen season, with most reporting sleep disturbance and headache, which negatively impacted their daily activities.…”

Section: Discussionsupporting

confidence: 84%

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Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Al-Asad

Al-Nazer

Al-Faqih

et al. 2017

JAA

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BackgroundOlive pollen is an important cause of respiratory allergy in the Middle East. In this study, the clinical characteristics of adults and children with confirmed allergic rhinitis (AR; with or without asthma) in Jordan were described, and the use of sublingual immunotherapy (SLIT) in a real-life clinical setting was assessed.MethodsThis retrospective observational study evaluated the clinical features of olive-induced allergy and the use of an SLIT solution of standardized extracts toward Ole e 1 given in a pre- and coseasonal scheme with a daily dose of 300 index of reactivity for two consecutive seasons. Inclusion criteria were as follows: ≥5 years of age, AR, proven olive sensitization, and at least 2 years follow-up after SLIT initiation. The following data were recorded at SLIT initiation: clinical characteristics, rhinitis and asthma symptom scores, and concomitant symptomatic medications. During follow-up and at the end of each season, the following data were recorded: symptom progression/scores, any changes to symptomatic medications, and treatment compliance. The secondary objective was to determine any effect on quality of life, use of concomitant AR medications, and treatment compliance.ResultsEighty-six patients with seasonal AR were included in this analysis (52.3% with coexisting asthma). Between the initiation of treatment and the end of second pollen season, symptoms of AR and asthma were decreased by 79.5% and 41.7%, respectively, with an improvement in quality of life score in 71.5% of the patients (P<0.0001 for all). Physicians reported that after 2 years of SLIT, there was an improvement in the symptoms of both AR (95.2%) and asthma (93.3%), with 98.8% of the patients showing good treatment compliance. A reduction in symptomatic medications was also found. SLIT was well tolerated with no systemic reactions being reported.ConclusionIn children and adults with olive-associated respiratory allergy in Jordan, the use of a pre- and coseasonal SLIT with a 300 index of reactivity daily dose is effective in reducing the clinical burden of AR and asthma with no tolerability issues.

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Section: Discussionsupporting

confidence: 84%

“…This schedule has been used and reported in a number of observational studies of this agent for allergic disease caused by other allergens 17,21–23. Treatment was well tolerated, and the high level of compliance across 2 years (98.8%) indicates that treatment was acceptable to both patients and (in the case of children) their parents.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Al-Asad

Al-Nazer

Al-Faqih

et al. 2017

JAA

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“…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]. In contrast, Ferrés et al [172] did not find any improvement in asthma severity. When SLIT efficacy and safety was compared in monosensitized and polysensitized children, the significant improvement in global clinical parameters was similar in both groups [173].…”

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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“…It has been well established that SLIT requires a high allergen dose for its efficiency to facilitate a take-up of sufficient amounts of allergens by sentinel dendritic cells within the oral mucosa or due to a lack of adjuvants by sublingual administration [46]. Even though a high dose and long courses of medication are necessary, SLIT is a safe therapeutic option for children, as has been recently reported by Ferrés et al [47]; although, in this study, the mild and local adverse reaction rate was at 23%; however, none of the cases from the study group showed an anaphylactic reaction. Similarly, in the clinical study by Eifan et al [40] it was demonstrated that SLIT was associated with clinical improvement and proved to be a safe mode of immunotherapy.…”

Section: Mucosal Tolerance: An Implication For Sublingual Immunothmentioning

confidence: 99%

Development of Mucosal Immunity in Children: A Rationale for Sublingual Immunotherapy?

Szczawińska-Popłonyk

2012

Journal of Allergy

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The mucosal immune system has bidirectional tasks to mount an effective defense against invading harmful pathogens and to suppress the immune response to alimentary antigens and commensal bacterial flora. Oral tolerance is a suppression of the mucosal immune pathway related to a specific immunophenotype of the dendritic cells and an induction of the regulatory T cells as well as with the silencing of the effector T cell response by anergy and deletion. The physiological dynamic process of the anatomical and functional maturation of the immune system occurring in children during pre- and postnatal periods is a significant factor, having an impact on the fine balance between the activation and the suppression of the immune response. In this paper, mechanisms of mucosal immunity and tolerance induction in terms of maturational issues are discussed with a special emphasis on the implications for a novel therapeutic intervention in allergic diseases via the sublingual route.

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Efficacy of high-dose sublingual immunotherapy in children allergic to house dust mites in real-life clinical practice

Abstract: This retrospective study indicates that high-dose SLIT in children with rhinitis caused by house dust mites is well-tolerated and could be an effective treatment.

Cited by 26 publications

References 23 publications

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

Evaluation of a sublingual immunotherapy solution in olive-induced respiratory allergy in Jordan: a retrospective observational study

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

Development of Mucosal Immunity in Children: A Rationale for Sublingual Immunotherapy?

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