title: Changing the route of immunotherapy administration: an 18-year survey in pediatric patients with allergic rhinitis and asthma.
abstract: Immunotherapy can be administered either sublingually (sublingual immunotherapy [SLIT]) or subcutaneously (subcutaneous immunotherapy [SCIT]). The rate of route switching, required by patients, can provide an indirect evaluation of patients' preferences and adherence. The authors retrospectively reviewed patients' files over an 18-year period to quantify the changes in the route of administration. The clinical records of children referred for respiratory allergy between 1994 and 2011 and prescribed with SLIT or SCIT were reviewed. The specific causes of the shift from SLIT to SCIT and vice versa were always assessed, with a special attention to adverse events. The records of 4933 children (2289 male patients, aged 4-18 years) were reviewed. Six hundred forty-eight patients received SCIT and 4285 patients received SLIT. Of the 4285 SLIT patients, 340 (7.9%) shifted to SCIT, mainly with Parietaria judaica and grasses. The 85.8% of the changes were caused by a perceived low efficacy. None of the parents required the route change for side effects. Of the 648 patients initially treated with SCIT, 54 (8.3%) shifted to SLIT, 85% of them for local or systemic side effects, but none for poor efficacy. The rate of SCIT/SLIT changes is, overall, low and because of poor efficacy for SLIT and side effects for SCIT.
authors.affiliation: Pediatric Allergy Unit of the Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Pajno
authors.forename: Lucia
authors.initials: L
authors.lastname: Caminiti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D055118:Medication Adherence; D057240:Patient Preference; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy*