A three-year prospective study of specific immunotherapy to inhalant allergens: evidence of safety and efficacy in 300 children with allergic asthma.
The effectiveness and safety of specific immunotherapy (SIT) in allergic diseases such as asthma have increasingly come under question. Some authors advocate eliminating SIT as a therapeutic option for allergic patients, since the risks associated with this form of asthma may outweigh its positive effects. However, in a review of twenty-nine controlled studies in 2077 children and an equal number of controls, 27 (93.1%) have shown the effectiveness of SIT in pediatric age for the treatment of asthma due to inhalant allergens (p < 0.0001). The scope of this study was to ascertain whether this form of therapy is safe and effective in pediatrics. 300 children (median age 4.4 years) with asthma due to pollen or house dust mite were prospectively followed for three years. They were randomly divided into two groups: the study group and control group, being almost equal in number of children and clinical characteristics such as sex and age. No child suffered severe reactions due to SIT. Children receiving SIT had significantly greater reductions in days (p = 0.0001) and nights (p = 0.0005) without asthma and drug usage (p = 0.0003), compared with drug-treated children. In addition, the number of asthma attacks (p = 0.0001), and the quality of life were significantly improved in the study group (p = 0.0001). These findings suggest that if suitable allergen extracts are used with close observation of therapeutic indications, and children are followed by their doctors as frequently as required, SIT is effective in the treatment of pediatric asthma, with few adverse effects.
Cantani
A
A
Department of Pediatrics, University of Rome La Sapienza, Italy.
Arcese
G
G
Lucenti
P
P
Gagliesi
D
D
Bartolucci
M
M
D000280:Administration, Inhalation; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D000818:Animals; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007167:Immunotherapy; D008297:Male; D008925:Mites / Q000276:immunology; D011058:Pollen / Q000276:immunology; D011852:Radioallergosorbent Test; D012882:Skin Tests
D000485:Allergens; D007073:Immunoglobulin E