Comparison of Long-term Efficacy of Subcutaneous Immunotherapy in Pediatric and Adult Patients With Allergic Rhinitis

Abstract

PurposeData comparing the long-term efficacy and safety of subcutaneous immunotherapy (SCIT) using house dust mite (HDM) in children and adults with allergic rhinitis (AR) are limited. This study aimed to compare the long-term effects of HDM-SCIT in a cohort of Chinese pediatric and adult patients with AR.MethodsA total of 124 pediatric and adult AR patients received HDM-SCIT for 3 years, with 118 patients being followed-up for 2 years. Prior to treatment (baseline), at the end of the 3-year treatment periods (third year) and 2 years after the discontinuation of treatment (fifth year), all patients were evaluated for total nasal symptom scores (TNSS), daily medication score (DMS), total combined score (TCS; symptoms [nasal + ocular] + DMS) and quality of life (QoL). Safety was assessed according to adverse events reported.ResultsAfter 3-year treatment, HDM-SCIT significantly improved symptoms and QoL scores at the end of the third and fifth years in both groups. Better improvements were observed in the third and fifth years based on baseline, in children compared to adults (TNSSΔ3: 6.66 vs. 5.41, P = 0.011; TCSΔ3: 4.30 vs. 3.83, P = 0.027 and TNSSΔ5: 6.16 vs. 4.86, P = 0.037; TCSΔ5: 4.11 vs. 3.62, P = 0.044).Shorter duration of AR history before SCIT (<10 vs. ≥10 years) resulted in better improvements at the end of the third and fifth years (TCSΔ3: 4.12 vs. 3.13, P = 0.036; TCSΔ5: 3.90 vs. 3.09, P = 0.033). HDM-SCIT was safe and comparable in both children and adults with AR.ConclusionsChildren with AR may achieve better long-term efficacy of HDM-SCIT than adults with AR.

Management of Allergic Patients During the COVID-19 Pandemic in Asia

“…Allergen-specific immunotherapy (AIT), including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), is widely applied to patients with asthma or AR in Asia. 19 20 21 22 AIT, especially SCIT, requires long-term regular contacts between HCWs and patients (>3 years). During the COVID-19 pandemic, home isolation strategy is necessary to control this highly contagious disease, and frequent hospital visits may increase the risk of exposure to the virus.…”

Novel therapeutic targets for allergic airway disease in children

“…Long-term effectiveness was reported for symptoms and quality of life after 3 years of treatment and 2 years after discontinuation of house dust mite (HDM) SCIT in both children and adults with AR, but the effect was greater in children 72. However, SLIT is easier and better tolerated than SCIT in children.…”

<p>Interactive Network Platform Improves Compliance and Efficacy of Subcutaneous Immunotherapy for Patients with Allergic Rhinitis</p>

“…The patients with a confirmed diagnosis of AR according to the Chinese guidelines for the diagnosis and treatment of allergic rhinitis were recruited from the Department of Otolaryngology Head and Neck Surgery in the participating academic institutions. 17 Participants were included if they (1) were ≥18 years of age; (2) were prescribed SCIT according to the guidelines and the physician's assessment and did not have any contraindications for SCIT; and (3) were proficient in using smartphones and had a smartphone. Participants were excluded if they (1) experienced a severe systemic reaction (rapid onset (<15 mins), widespread urticaria, angioedema or severe asthma) or anaphylactic shock of unknown origin during treatment; (2) were participating in other projects related to SCTI management; or (3) were suffering from other serious physical or psychological conditions, such as cancer, chronic kidney failure, schizophrenia, and autism.…”

“…1 Subcutaneous immunotherapy (SCIT) is one of the main methods of implementing AIT, and it has been shown to have the potential to prevent the further development of allergic sensitization and asthma in patients with AR. 2,3 To ensure the long-lasting clinical effects following the end of treatment, the SCIT treatment duration should be at least 3 years. 4 The effectiveness of SCIT is largely influenced by patient compliance with this therapy.…”