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

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

doi:10.1111/pai.13261

Cited by 12 publications

(4 citation statements)

References 28 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: 55%

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: 55%

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: 45%

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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“…Sánchez-Borges et al (20) stated that accelerated build up protocols in cluster immunotherapy are risk factors for systemic reactions. In another study, it was reported that local reactions were more frequent in the build-up phase in pediatric patients who underwent grass pollen immunotherapy, and systemic reactions were observed more frequently in the maintenance phase, although not statistically significant (21). In the current study, when large local and systemic reactions are considered separately, no differences could be noted between build-up and maintenance phases, while the total number of adverse events were significantly higher during the build-up phase as compared to the maintenance phase.…”

Section: Discussionmentioning

confidence: 89%

Local and Systemic Reactions due to Subcutaneous Allergen Immunotherapy: Our Single-Center 5-Year Experience

Aytekin¹,

Yıldız

Çölkesen

et al. 2022

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Objective: Subcutaneous allergen immunotherapy (SCIT) currently represents the only disease-modifying therapeutic option for the treatment of allergic rhinitis/conjunctivitis, asthma, and venom sensitization. Although SCIT represents a fairly safe therapeutic option in the hands of experienced physicians and canters, it may also be associated with certain adverse effects. In this study, we describe the local and systemic adverse effects in our adult patients undergoing immunotherapy over a 5-year period in an effort to define the causative factors. Material and Methods:A total of 4413 injections administered to 119 patients (58 female, 61 male) were analysed.Results: A total of 119 patients with a mean age of 33.7±12 years were included (Female: 58, 48%; Male: 61, 51.3%). In the total population of 119 patients, 6 (5%) developed local reactions, 21 (17.7%) developed large local reactions, and 9 (7.6%) had systemic reactions. Of all injections administered throughout the study period, 0.14% were associated with local reactions, 0.48% with large local reactions, and 0.20% with systemic reactions. Four patients with systemic reactions (44.4%) required epinephrine injection. Patients who did or did not develop adverse effects were significantly different with regard to IgE levels and eosinophil counts (p=0.001 and p=0.002). There was a significant difference between the rates of total adverse reactions developing during the build-up or maintenance phase (p=0.025). Conclusion:Clinicians' awareness regarding the local, large local, and systemic reactions associated with SCIT should be improved, and clinicians should be more careful during the immunotherapy, especially in the build-up phase, for adverse events.

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

Cited by 12 publications

References 28 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

Local and Systemic Reactions due to Subcutaneous Allergen Immunotherapy: Our Single-Center 5-Year Experience

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