Subcutaneous venom immunotherapy in children

Çetinkaya, Pınar Gür; Esenboğa, Saliha; Soyer, Özge; Tuncer, Ayfer; Şekerel, Bülent Enis; Şahiner, Ümit Murat

doi:10.1016/j.anai.2018.01.015

Cited by 12 publications

(10 citation statements)

References 24 publications

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“…Adverse reactions were also reported in several studies as a reason for drop-outs in 3.9 to −11% of drop-outs [18,21]. Systemic reactions were also one of the leading reasons for drop-out (14.3%) in the present study although it was not reported frequently in our center previously [22,23]. In contrast to literature, the cost of SCIT was not a reason for drop-out in the present study, most likely because it is paid for social security system of our country.…”

Section: Discussionsupporting

confidence: 58%

Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Aytekin

Soyer

Şekerel

et al. 2021

Int Arch Allergy Immunol

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Background: Subcutaneous allergen immunotherapy (SCIT) is an effective treatment for allergic rhinitis, asthma, and venom allergy. Compliance is essential for SCIT to obtain maximal benefit as it is a long-term treatment. Objectives: This study aimed to determine the level of real-life SCIT compliance in pediatric patients and the associated factors. Additional aims were to determine how SCIT compliance was affected by the COVID-19 pandemic and why some patients dropped out SCIT. Method: Pediatric patients diagnosed with allergic rhinitis, allergic asthma, or venom allergy that received SCIT between September 2012 and July 2020 were analyzed. Results: The study included 201 children (66.7% male) with a median (interquartile range) age of 12.8 years (9.4–15.2) at the time of the first SCIT injection. The overall compliance rate before COVID-19 pandemic was 86.1%. Short SCIT follow-up time and venom anaphylaxis were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country (32.1%), symptom improvement (17.8%), treatment ineffectiveness (14.2%), and adverse reactions (14.2%). Among the 108 patients that were still receiving SCIT during the COVID-19 pandemic, 31 (28.7%) dropped out the therapy. The most frequent reasons for drop-out were fear of being infected with COVID-19 (35.4%) and thinking that the AIT practise stopped due to COVID-19 pandemic (29%). Male gender and older age were found to be the independent risk factors for drop-out of SCIT. Conclusions: Real life compliance in children was found 13.9% and it was higher than adults. Nearly one-third of children dropped out during the COVID-19 pandemic. Male gender and older age are associated with SCIT drop-out during the COVID-19 pandemic.

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Section: Discussionsupporting

confidence: 58%

Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Aytekin

Soyer

Şekerel

et al. 2021

Int Arch Allergy Immunol

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“…Adverse reactions were also reported in several studies as a reason for drop-outs in 3,9% to -11% of drop-outs 19,21 . Systemic reactions were also one of the leading reasons for drop-out (14,3%) in the present study although it was not reported frequently in our center previously 22,23 (24). In contrast to literature, cost was not a reason for drop-out in the present study as AIT treatment is covered by social security system of our country.…”

Section: Discussionmentioning

confidence: 47%

Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Aytekin

Soyer

Şahiner

2020

Preprint

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Background: Allergen immunotherapy(AIT) is an effective treatment for allergic rhinitis, asthma and venom allergy. Compliance is essential for AIT to obtain maximal benefit as it is a long term treatment. Objective: We aimed to evaluate the real life compliance of children with subcutaneous immunotherapy(SCIT) and tried to document the factors associated. Additionally how COVID-19 pandemic effected the compliance of the patients and the reasons of drop-outs were also evaluated. Method: Patients diagnosed with allergic rhinitis, allergic asthma or venom allergy and treated with SCIT between 2012 September, 2020 July were analyzed. Results: The study population comprised of 201 children (66,7% male) with a median (interquartile range) age of 12,8(9,4-15,2) years during the first injection of SCIT. The overall compliance rate before COVID-19 pandemic was 86,1%. Short AIT follow up time and venom allergy were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country(32,1%), improvement of symptoms(17,8%), ineffectiveness(14,2%) and adverse reactions(14,2%). During COVID-19 pandemic, among 108 patients receiving AIT, 31(28,7%) dropped out the therapy. The most frequent reasons for drop-outs were fear of being infected with COVID-19(35,4%) and thinking that the AIT practise stopped due to COVID-19 pandemic(29%). Male gender and older age were found to be the independent risk factors for drop out. Conclusion: The real life compliance in children was higher than in adults. Nearly one third of children dropped out during COVID-19 pandemic. Male gender and older age are associated with AIT drop out during COVID-19 pandemic. Conclusion:The real life compliance in children was higher than in adults. Nearly one third of children dropped out during COVID-19 pandemic. Male gender and older age are associated with AIT drop out during COVID-19 pandemic.

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“…Various studies confirm the safety of an ultra-rush protocol in children [6,7]. The most common adverse reaction described is mostly local reactions at the injection site with redness and/or minor swelling [8,9,[15][16][17]. Objective systemic reactions are hardly detectable or are usually of lesser clinical severity and can be managed well under inpatient conditions [15].…”

Section: Discussionmentioning

confidence: 99%

Tolerability, course and follow-up of specific immunotherapy using a modified ultra-rush procedure in children and adolescents with insect venom allergy

2021

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Summary Background Specific immunotherapy with insect venom (hymenoptera venom (HG)-AIT) is an effective and the only causal treatment for patients with systemic reactions due to IgE-mediated insect venom allergy. The present study investigated the quality of care after bee and wasp venom allergy, the tolerability of modified ultra-rush immunotherapy and the course after the conclusion of maintenance therapy in children and adolescents. Studies on the quality of life of children with insect venom allergy are scarce. Methods The efficacy, safety and tolerability of an ultra-rush protocol was analysed in 114 patients aged 4–17 years with insect venom allergy. After the end of HG-AIT, patients were contacted by questionnaire and asked to report on the quality of care as well as the course of insect venom allergy, including accidental stinging events. Quality of life was validated using the established questionnaire VQLQ‑d (Vespid Quality of Life Questionnaire), which is also used for bee venom allergy patients. Results Discontinuation of the initial therapy was not necessary in any patient. Side effects were mostly mild and did not require treatment. In 16 patients, a new sting reaction occurred during maintenance therapy, in another 15 patients a sting event was documented after cessation of HG-AIT. The intensity of the reaction to the accidental insect bite according to the severity classification after Ring and Messmer decreased from an average of 2.3 to 0.9 in these patients. This corresponds to a decrease of 61%. An emergency kit was carried by 70% of the patients, the expiry date of which, however, had already passed in almost 40% of the respondents. After the end of the therapy, most patients were not under any medical care or had never been to a check-up (92%). The evaluation of the VQLQ‑d showed a medium to low level of stress during or after therapy. Discussion Ultra-rush AIT in childhood and adolescence is safe, tolerable and effective. HG-AIT has a lasting positive effect on the health-related quality of life of patients. However, after the end of HG-AIT, there are deficits in the follow-up and care of the patients.

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Subcutaneous venom immunotherapy in children

Cited by 12 publications

References 24 publications

Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance and Effect of COVID-19 Pandemic on Compliance

Tolerability, course and follow-up of specific immunotherapy using a modified ultra-rush procedure in children and adolescents with insect venom allergy

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