Side effects during subcutaneous immunotherapy in children with allergic diseases

Tophof, Max A.; Hermanns, Anne; Adelt, Thomas; Eberle, Peter; Gronke, Christine; Friedrichs, Frank; Knecht, Roland; Mönter, Ernst; Schöpfer, Helmut; Schwerk, Nicolaus; Steinbach, Jörg; Umpfenbach, Hans-Ulrich; Weißhaar, Christian; Wilmsmeyer, Brigitte; Bufe, Albrecht

doi:10.1111/pai.12847

Cited by 31 publications

(23 citation statements)

References 16 publications

(34 reference statements)

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“…Anaphylaxis to RCM occurred in 1.2% of our patients, percentage similar to that observed by others [11,25,38].Severe reactions attributed to RCM have been decreasing due to the fact that, currently, high osmolality ionic formulations are no longer used [38]. In this registry, anaphylaxis during allergen-specific immunotherapy was a rare event, lower than in other case-series [8,16,22,37], confirming the current safety of this treatment [41,42]. Idiopathic anaphylaxis may account for up to 20% of all cases of anaphylaxis [1,23,43];however, this diagnosis of exclusion was rare (2%) in our registry.…”

Section: Discussionsupporting

confidence: 89%

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Gáspár

Santos

Faria

et al. 2022

J Investig Allergol Clin Immunol

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Section: Discussionsupporting

confidence: 89%

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Gáspár

Santos

Faria

et al. 2022

J Investig Allergol Clin Immunol

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“…In some Chinese patients' studies, SRs occurred in 12.26-18.49% of patients and 0.72-3.28% of injections in children. We also found the majority of the SRs were grade 1 and grade 2 reactions, which was consistent with previous studies [31,32]. Only 2 /91 (4.55%) patients experienced grade 3 reactions within 30 min after injection and responded well to rescue medication, no patient had grade 4 or grade 5 reaction.…”

Section: Discussionsupporting

confidence: 92%

Safety of house dust mite subcutaneous immunotherapy in preschool children with respiratory allergic diseases

Yang

Huang

et al. 2021

Ital J Pediatr

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Background Allergen immunotherapy (AIT) is the only causal therapy for IgE-mediated allergy. There is less evidence about the safety and efficacy of AIT especially subcutaneous immunotherapy (SCIT) in children under 5 years old. We aimed to investigate the side effects and associated risk factors of house dust mite (HDM) SCIT in preschool children with respiratory allergic diseases. Methods The preschool children who had HDM-related allergic rhinitis with/without asthma were enrolled and undergone standardized HDM SCIT in our department from June 2013 to December 2019. Local reactions (LRs) and systemic reactions (SRs) were recorded and categorized according to World Allergy Organization recommendations. Demographic data and other therapeutic-related parameters were also recorded to investigate potential risk factors for these side effects. Results A total of 91 children (60 boys, 65.93%; 31 girls, 34.07%; mean age 4.13 years old) were included in the study. Among the 91 patients, 3109 SCIT injections were recorded, 62/91 (68.13%) experienced 186 immediate LRs, 4 /91(4.40%) experienced 6 delayed LRs, 11/91 (12.09%) children experienced 44 immediate SRs, 21/44 (47.73%) were grade 1 SRs, 21/44 (47.73%) were grade 2, 2/44 (4.55%) were grade 3, no grade 4 or 5 SRs occurred. Furthermore, 1/91 (1.10%) experienced 1 delayed SRs, manifested by urticaria 2 days later after allergen injection. 9/91 (9.89%) experienced 2 or more times SRs. Multivariable logistic regression analysis showed BMI (OR 1.506; 95%CI 1.091 to 2.079; p < 0.05) and sIgE against HDM (OR 1.497; 95%CI 1.082 to 2.071; p < 0.05) were risk factors for LRs. No variable was found to correlate with SRs (all p > 0.05). Conclusions HDM subcutaneous immunotherapy is considered to be safe in preschool children with respiratory allergic diseases. Higher BMI and HDM sIgE level in children are risk factors for developing LRs. The incidence of SRs and the rate of severe SRs are low in preschool children.

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“…When looking at the ratio of the patients who experienced adverse effects, the ratio of the participants who experienced the local reactions was 26.0%‐86.0%, 28 and the ratio of the participants who had systemic reactions was 5.0%‐7.0% 29 . In a study consisting of children, 30 the ratio of local reactions was 75.2% and that of systemic reactions was 9.3%. In another study, 18 local, large local, and systemic reactions have been reported in children as 11.9%, 5.0%, and 4.7%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Systemic and large local reactions during subcutaneous grass pollen immunotherapy in children

Çetinkaya

Kahveci

Esenboğa

et al. 2020

Pediatric Allergy Immunology

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Background Subcutaneous immunotherapy (SCIT) is the allergen‐specific curative treatment of allergic rhinitis. Adverse effects, most of which are local, can be observed during the immunotherapy. These adverse effects have been reported more frequently during the pollen season. The purpose of this study was to estimate the rate of local, large local, and systemic reactions during the treatment, to determine the relationship between adverse reactions and the season in which these reactions occur, as well as the risk factors for adverse reactions during the grass pollen–specific SCIT treatment in children. Methods We retrospectively collected and analyzed the data of 261 children who administered grass pollen SCIT between 2008 and 2018. Results A total of 261 children (177, 67.8% male), who received grass pollen SCIT, with a mean (±SD) age of 12.0 ± 3.0 years at the initiation of SCIT were enrolled to the study. The number of the patients who experienced local and large local reactions was 109 and 30, respectively. In addition, the number of the patients with systemic reactions was 35. After the 12 284 injections, local reactions occurred in 357 (2.9%), and this was followed by systemic reaction as 55 (0.4%) and large local reactions as 40 (0.3%). Frequency of local (P < .001) and systemic reactions (P = .003) was higher during grass pollen season than out of the grass pollen season. In multivariate analysis, initiation of SCIT during the grass pollen season [OR:7.351, 95%CI:1.532‐35.279, P = .013] and experiencing local reactions [OR:4.214, 95%CI:2.159‐8.224, P < .001] were independent predictors for the development of large local and systemic reactions. Conclusion SCIT, in which only mild‐to‐moderate systemic reactions occurred, is safe for the treatment of allergic rhinitis in children. Our study revealed that previous local reactions and initiation of immunotherapy during the grass pollen season were the predictors for large local and systemic reactions during SCIT in children.

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Side effects during subcutaneous immunotherapy in children with allergic diseases

Cited by 31 publications

References 16 publications

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Safety of house dust mite subcutaneous immunotherapy in preschool children with respiratory allergic diseases

Systemic and large local reactions during subcutaneous grass pollen immunotherapy in children

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