Efficacy of long‐term sublingual immunotherapy as an adjunct to pharmacotherapy in house dust mite‐allergic children with asthma

Abstract

Although sublingual immunotherapy (SLIT) is accepted to be a viable alternative of specific-allergen immunotherapy, the efficacy of long-term SLIT in asthmatic children is not well established. The efficacy of 3 yr of SLIT in addition to pharmacotherapy was compared with pharmacotherapy alone in a prospective, open, parallel-group, controlled study. Children with asthma aged 4-16 yr, sensitive to house dust mite (HDM) were followed up for a run-in period of 1 yr and then grouped as those who would receive SLIT + pharmacotherapy (n = 62) or pharmacotherapy alone (n = 28). All patients were evaluated based on symptom-medication scores and lung function tests every 3 months, as well as skin-prick test and serum total immunoglobulin E (IgE) levels annually for 3 yr. Children in the SLIT + pharmacotherapy group demonstrated significantly lower mean daily dose and annual duration of inhaled corticosteroid (ICS) usage when compared with controls. At the end of the 3 yr, within-group comparisons revealed statistically significant decreases in the dose and duration of ICS only in the SLIT group. Furthermore, 52.4% of subjects in the SLIT + pharmacotherapy group were able to discontinue ICS treatment for at least 6 months, which was only 9.1% for the pharmacotherapy group. Three years of SLIT as an adjunct to pharmacotherapy resulted in reduction of both the duration and dose of ICSs and successful discontinuation of ICSs along with improvement in lung functions in HDM-allergic children with asthma.

Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial

“…Sublingual immunotherapy (SLIT) appears to be associated with a lower incidence of systemic reactions and in a long-term treatment as an adjunct to pharmacotherapy results in the reduction of both the duration and the dose of inhaled corticosteroids and successful discontinuation along with an improvement of lung functions [6,7].…”

Allergen-Specific Immunotherapy in Children with Pollinosis

“…Высокая эффективность АСИТ, проводимой неинва-зивным сублингвальным методом, меньшая травматич-ность по сравнению с парентеральной иммунотерапией позволяют рекомендовать ее при аллергических заболе-ваниях у детей, особенно младшего возраста [14,17].…”

“…В нескольких других исследованиях среди детей дошколь-ного возраста также была подтверждена безопасность проведения сублингвальной АСИТ [17]. При анализе нежелательных явлений установлено, что у детей всех исследуемых групп они проявлялись на высоких дозах вводимых аллергенов и при нарушении диеты в течение курса иммунотерапии (употребление пищевых аллергенов, имеющих общие антигены с пыль-цой -орехи, яблоки, киви и т.д.…”

Sublingual Desensitization in Patients with Wasp Venom Allergy: Preliminary Results

“…Double-blind, placebo-controlled studies have shown the efficacy and the safety of SLIT both in allergic rhinoconjunctivitis and asthma (16)(17)(18)(19)(20). Ultra-rush regimens of SLIT induction have been carried out with good safety and efficacy profiles (21)(22).…”