Effectiveness and adverse reactions to subcutaneous immunotherapy in children with allergic rhinitis/asthma

Safety of allergen immunotherapy in children

“…The incidence of any systemic reaction was 0.14% per injection, similar to other published incidence rates of SCIT systemic reactions [8]. Most systemic reactions (82%) occurred during maintenance phase and reported as Grade 1 (53.8%) or Grade 2 (25%) in severity; 16.6% of SRs required epinephrine [14] There were no fatalities and no difference in reaction rates between build-up and maintenance phase of SCIT [14]. Similarly, a pediatric retrospective cohort study evaluating the side effects of SCIT among children with allergic rhinitis due to house dust mite (HDM) allergy found a similar incidence of adverse reactions at 2.27% (699 adverse events/30 744 injections) with 8.38% of patients experiencing systemic reactions, but a slightly higher incidence of systemic reactions at 0.53% per injection [15 ▪ ].…”

“…effectiveness and safety of 33 008 injections in 344 children receiving SCIT, and found that 162 (56.7%) of patients had 840 (2.5%) treatment-related adverse reactions during SCIT treatment. The majority of patients (68.9%) experienced either local or large location reactions (LLR, defined as pruritus and/or erythema > 5 cm at the site of injection), with 9% of patients experiencing a systemic reaction based on WAO grading criteria [14]. The incidence of any systemic reaction was 0.14% per injection, similar to other published incidence rates of SCIT systemic reactions [8].…”

“…A large systemic review of 29 pediatric randomized controlled trials (RCTs) and non-RCTs looking at SCIT safety outcomes in allergic asthma demonstrated that systemic reactions, defined as any symptom outside the injection site, occurred in 6–17% of active treatment arms with anaphylaxis being reported in 2% of patients receiving SCIT in trials [13] Duman Senol et al [14] performed a recent retrospective study of effectiveness and safety of 33 008 injections in 344 children receiving SCIT, and found that 162 (56.7%) of patients had 840 (2.5%) treatment-related adverse reactions during SCIT treatment. The majority of patients (68.9%) experienced either local or large location reactions (LLR, defined as pruritus and/or erythema > 5 cm at the site of injection), with 9% of patients experiencing a systemic reaction based on WAO grading criteria [14]. The incidence of any systemic reaction was 0.14% per injection, similar to other published incidence rates of SCIT systemic reactions [8].…”

“…There have been some recent publications looking specifically at frequencies of SCIT-related systemic reactions in children. A large systemic review of 29 pediatric randomized controlled trials (RCTs) and non-RCTs looking at SCIT safety outcomes in allergic asthma demonstrated that systemic reactions, defined as any symptom outside the injection site, occurred in 6-17% of active treatment arms with anaphylaxis being reported in 2% of patients receiving SCIT in trials [13] Duman Senol et al [14] performed a recent retrospective study of…”

“…Practices with a higher percentage of individuals with asthma on SCIT had significantly higher rates of grade 3 systemic reactions, and more specifically, practices reporting greater than 20% of patients with severe asthma, had significantly higher rates of Grade 1 and Grade 2 systemic reactions [9 & ]. In a pediatric study, nearly 50% of patients with SRs to SCIT had been diagnosed with asthma, with the majority (75%) of these identified with partially controlled or uncontrolled asthma [14].…”