Efficacy of high-dose sublingual immunotherapy in children allergic to house dust mites in real-life clinical practice.
BACKGROUND
The aim of the study was to evaluate the efficacy and safety of high-dose mite sublingual immunotherapy (SLIT) administered in children with allergic rhinitis in real-life clinical practice. Moreover, we analysed the clinical course of asthma severity.


METHODS
Retrospective, observational, monocentre study. Medical records of patients treated between 2001 and 2008 were reviewed. Patients received a standardised Dermatophagoides pteronyssinus+Dermatophagoides farinae extract (300 IR/ml) manufactured by Stallergenes (Staloral(®) 300). Patients were evaluated before SLIT initiation and at 6, 12, 24, 36 and 48 months. Global assessment of SLIT efficacy was measured using a visual analogue scale (VAS) and a rhinitis medication consumption score (RMCS). A global asthma score was used to estimate the clinical course of asthma severity.


RESULTS
We obtained data from 78 patients, 43.6% male. The mean (± SD) age was 11.0 ± 3.0 years. Most patients (69.2%) suffered from allergic rhinitis plus asthma. Patient evaluation of allergy severity (VAS) revealed a highly significant improvement between baseline and six months (p < 0.001, Wilcoxon test): 4.0 ± 1.7 cm vs. 7.3 ± 4.6 cm. This improvement was maintained throughout the four-year follow-up period. The use of medications (RMCS) was significantly reduced in the first six months (4.6 ± 2.5 points at baseline vs. 0.8 ± 1.6 points at six months visit, p < 0.001, Wilcoxon test) and remained very low until the end of follow-up. We did not find a temporal improvement in asthma severity.


CONCLUSIONS
This retrospective study indicates that high-dose SLIT in children with rhinitis caused by house dust mites is well-tolerated and could be an effective treatment.
Ferrés
J
J
Paediatric Asthma Unit, Hospital de Sant Pau, Barcelona, Spain.
Justicia
J-L
JL
García
M P
MP
Muñoz-Tudurí
M
M
Alvà
V
V
D000286:Administration, Sublingual; D000293:Adolescent; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage*; D001249:Asthma / Q000517:prevention & control*; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000517:prevention & control*; D008297:Male; D039981:Pyroglyphidae / Q000276:immunology*; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000517:prevention & control*
D039741:Antigens, Dermatophagoides