Safety and tolerability of ultra-rush induction, less than one hour, of sublingual immunotherapy in children.
BACKGROUND
The safety and tolerability of sublingual immunotherapy (SLIT) has been documented in allergic patients both in the build-up phase as well as during maintenance, but only two studies have evaluated the occurrence of adverse reactions with an ultra-rush regimen of SLIT induction in a mixed paediatric/adult population. Moreover one of these two studies used a chemically modified extract (allergoid). The aim of the present study was to evaluate the occurrence of immediate or late adverse reactions in allergic children after a very fast (40 min) ultra-rush SLIT induction with two different allergen extract solutions.


METHODS
We studied 100 children (64 boys, mean age of 9.6 years, range 3.5-16.8), with a history of intermittent/persistent rhinitis and/or intermittent/mild persistent asthma due to inhalant allergens. The ultra-rush build-up phase involved the administration, every 10 min, of increasing doses of the highest-concentration vial of SLIT of two different manufacturers (Anallergo and Stallergènes).


RESULTS
All patients completed the treatment, side-effects have been recorded in 19% of the cases: 10% within 1 h after the build-up phase, 7% within 48 h and 2% mixed. A major difference (p = 0.0001) was recorded between Anallergo (6 patients, 8.7%) and Staloral (13 patients, 41.9%), but all the reactions were mild: principally oral symptoms, in 1 case rhinorrhoea and cough, and delayed abdominal pain and diarrhoea in another patient.


CONCLUSIONS
No severe adverse reactions were observed with this ultra-rush SLIT induction also in the paediatric age; statistical differences have been documented between the two different extracts.
Tripodi
S
S
Pediatric Allergy Unit, S. Pertini Hospital, Rome, Italy. salvatore.tripodi@fastwebnet.it
Di Rienzo Businco
A
A
Benincori
N
N
Scala
G
G
Pingitore
G
G
D000286:Administration, Sublingual; D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003233:Conjunctivitis, Allergic / Q000628:therapy; D003876:Dermatitis, Atopic / Q000628:therapy; D003888:Desensitization, Immunologic / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000188:drug therapy*; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000628:therapy
D000485:Allergens