BACKGROUND: The minimum age to start specific immunotherapy with inhalant allergens in children has not been clearly established, and position papers discourage its use in children younger than 5 years. OBJECTIVE: To assess the safety of high-dose sublingual-swallow immunotherapy (SLIT) in a group of children younger than 5 years. METHODS: Sixty-five children (51 boys and 14 girls; age range, 38-80 months; mean +/- SD age, 60 +/- 10 years; median age, 60 months) were included in this observational study. They were treated with SLIT with a build-up phase of 11 days, culminating in a top dose of 300 IR (index of reactivity) and a maintenance phase of 300 IR 3 times a week. The allergens used were house dust mites in 42 patients, grass pollen in 11 patients, olive pollen in 5 patients, Parietaria pollen in 4 patients, and cypress pollen in 3 patients. All adverse reactions and changes in the treatment schedule were compared in 2 subgroups: children 38 to 60 months old and children 61. to 80 months old. RESULTS: The average cumulative dose of SLIT was 36,900 IR. Adverse reactions were observed in 11 children, none of them severe enough to require discontinuation of immunotherapy. Six reactions occurred in the 60 months or younger age group and 7 in the older than 60 months age group, with no differences between these 2 groups. CONCLUSION: High-dose immunotherapy in children younger than 5 years does not cause more adverse reactions than in children aged 5 to 7 years. There is no reason to forbear studies on safety and efficacy of these preparations in young children.
BACKGROUND: The minimum age to start specific immunotherapy with inhalant allergens in children has not been clearly established, and position papers discourage its use in children younger than 5 years. OBJECTIVE: To assess the safety of high-dose sublingual-swallow immunotherapy (SLIT) in a group of children younger than 5 years. METHODS: Sixty-five children (51 boys and 14 girls; age range, 38-80 months; mean +/- SD age, 60 +/- 10 years; median age, 60 months) were included in this observational study. They were treated with SLIT with a build-up phase of 11 days, culminating in a top dose of 300 IR (index of reactivity) and a maintenance phase of 300 IR 3 times a week. The allergens used were house dust mites in 42 patients, grass pollen in 11 patients, olive pollen in 5 patients, Parietaria pollen in 4 patients, and cypress pollen in 3 patients. All adverse reactions and changes in the treatment schedule were compared in 2 subgroups: children 38 to 60 months old and children 61. to 80 months old. RESULTS: The average cumulative dose of SLIT was 36,900 IR. Adverse reactions were observed in 11 children, none of them severe enough to require discontinuation of immunotherapy. Six reactions occurred in the 60 months or younger age group and 7 in the older than 60 months age group, with no differences between these 2 groups. CONCLUSION: High-dose immunotherapy in children younger than 5 years does not cause more adverse reactions than in children aged 5 to 7 years. There is no reason to forbear studies on safety and efficacy of these preparations in young children.
Authors: G Walter Canonica; Jean Bousquet; Thomas Casale; Richard F Lockey; Carlos E Baena-Cagnani; Ruby Pawankar; Paul C Potter; Philippe J Bousquet; Linda S Cox; Stephen R Durham; Harold S Nelson; Giovanni Passalacqua; Dermot P Ryan; Jan L Brozek; Enrico Compalati; Ronald Dahl; Luis Delgado; Roy Gerth van Wijk; Richard G Gower; Dennis K Ledford; Nelson Rosario Filho; Erkka J Valovirta; Osman M Yusuf; Torsten Zuberbier Journal: World Allergy Organ J Date: 2009-11-19 Impact factor: 4.084
Authors: Giorgio Walter Canonica; Linda Cox; Ruby Pawankar; Carlos E Baena-Cagnani; Michael Blaiss; Sergio Bonini; Jean Bousquet; Moises Calderón; Enrico Compalati; Stephen R Durham; Roy Gerth van Wijk; Désirée Larenas-Linnemann; Harold Nelson; Giovanni Passalacqua; Oliver Pfaar; Nelson Rosário; Dermot Ryan; Lanny Rosenwasser; Peter Schmid-Grendelmeier; Gianenrico Senna; Erkka Valovirta; Hugo Van Bever; Pakit Vichyanond; Ulrich Wahn; Osman Yusuf Journal: World Allergy Organ J Date: 2014-03-28 Impact factor: 4.084
Authors: Gian Luigi Marseglia; Cristoforo Incorvaia; Mario La Rosa; Franco Frati; Francesco Marcucci Journal: Ital J Pediatr Date: 2009-10-23 Impact factor: 2.638