Preventive effects of sublingual immunotherapy in childhood: an open randomized controlled study

Marogna, Maurizio; Tomassetti, Dante; Bernasconi, Antonella; Colombo, Fausto; Massolo, Alessandro; Businco, Andrea Di Rienzo; Canonica, Giorgio Walter; Passalacqua, Giovanni; Tripodi, Salvatore

doi:10.1016/s1081-1206(10)60211-6

Cited by 218 publications

(206 citation statements)

References 29 publications

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“…The safety profile seems not to be different in very young children (7,8). Similarly to injection immunotherapy, the literature would suggest that SLIT is capable of preventing the onset of new sensitizations and of reducing the risk of asthma onset in pediatric patients with allergic rhinitis (9,10). The most recent controlled trials (11)(12)(13)(14)(15)(16), involving hundreds of subjects, have clearly demonstrated, at least for grass pollen, a clinical efficacy over placebo far greater than the recommended 20% (17), in addition to a dosedependent effect.…”

Section: Introductionmentioning

confidence: 99%

Administration regimens for sublingual immunotherapy to pollen allergens: What do we know?

Lombardi

Incorvaia²,

Braga

et al. 2009

Allergy

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The modalities of administration of sublingual immunotherapy (SLIT), including dosing, build‐up phase, duration of the treatment, and frequency of the maintenance dose are largely variable. In the case of pollen (SLIT), the complexity increases, since preseasonal, coseasonal and pre‐coseasonal regimens can be used. The administration regimens are of relevance from a practical point of view, but can also have economic implications. We review herein the available literature (randomized double blind controlled studies) on pollen SLIT, in order to derive experimentally‐supported suggestions about the regimens of administration that should be preferred.

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Section: Introductionmentioning

confidence: 99%

Administration regimens for sublingual immunotherapy to pollen allergens: What do we know?

Lombardi

Incorvaia²,

Braga

et al. 2009

Allergy

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“…Our search strategy identified 1378 unique publications, including over 338 peer-reviewed studies published from inception to June 30, 2015 finally retrieved , of which 18 met the inclusion criteria (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). We excluded the Jacobsen study (38), because the outcome was reported in a subgroup of patients regardless of the treatment received, the Eifan (39) Acquistapace (40), Szepfalusi (41), and Shao (42) studies because they were not long-term studies (<3 years of treatment/follow-up).…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 shows descriptive data for the 18 systematically reviewed studies (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and seven adult studies (31-37) included a total of 11 106 patients (1049 children, 10 057 adults), of which 8369 (75.6%) were included only in the Purello D'Ambrosio study (31). Nine of 18 studies were conducted in Italy (21,22,24,25,29,31,(33)(34)(35), four in Turkey, and (26)…”

Section: Resultsmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and seven adult studies (31-37) included a total of 11 106 patients (1049 children, 10 057 adults), of which 8369 (75.6%) were included only in the Purello D'Ambrosio study (31). Nine of 18 studies were conducted in Italy (21,22,24,25,29,31,(33)(34)(35), four in Turkey, and (26)(27)(28)30) the remaining five in other European countries (20,23,32,36,37). The Durham study is the only long-term follow-up of a previous RCT (37).…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of allergen immunotherapy in reducing the likelihood of developing new allergen sensitizations: a systematic review

Bona

Plaia

Leto-Barone

et al. 2017

Allergy

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Background: Guidelines and position papers indicate that allergen immunotherapy (AIT) is the only disease-modifying treatment, including prevention of the onset of new allergen sensitizations. However, this preventive effect was shown by only a few observational studies. Our aim was to systematically review the efficacy of AIT in preventing the onset of new allergen sensitizations. Methods: Computerized bibliographic searches of Medline, EMBASE, and the Cochrane Library (through June 2015) were supplemented with manual searches of reference lists. Observational studies or randomized controlled trials with a longterm observation period were included. Paired reviewers extracted data about study characteristics and assessed biases. The end point was the risk difference in the onset of new allergen sensitizations between patients treated with AIT and pharmacotherapy. The strength of the evidence was graded based on the risk of bias, consistency, and magnitude of effect, according to the GRADE Working Group's guide. Results: Eighteen studies (1049 children, 10 057 adults) met the inclusion criteria. The risk of bias was high in all but one study. Low evidence supports the position that AIT prevents the onset of new allergen sensitizations, with 10 of 18 studies reporting a reduction in the onset of new sensitizations in patients treated with AIT vs placebo. Small studies and studies with a shorter follow-up showed the highest benefit of AIT. Conclusions: The overall evidence provides a low-grade level of the evidence supporting the efficacy of AIT in preventing the onset of new allergen sensitizations, but high-quality studies could change this estimate.

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“…9,47 El efecto preventivo del desarrollo de nuevas sensibilizaciones fue demostrado tanto para la modalidad subcutánea 48,51 como sublingual. 52 Los cambios inmunológicos provocados por la inmunoterapia se han observado desde los primeros años de la vida. En una reciente investigación, la ITSL utilizada en niños preescolares demostró ser una alternativa segura, que produjo un aumento del anticuerpo bloqueador IgG y una estimulación de la IL-10, que indujo la tolerancia alérgeno específica.…”

Section: Intervención Inmunológica Inmunoterapia Alérgeno Específicaunclassified

Prevención de las enfermedades alérgicas en la infancia: entre la teoría y la realidad

2016

Arch Argent Pediat

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RESUMENLas enfermedades alérgicas tienen una prevalencia creciente de modo universal y ocasionan alto impacto sanitario. La investigación está dirigida al estudio de los factores etiológicos y de riesgo de estas enfermedades, que pueden ser potencialmente modificados con estrategias de prevención primaria, secundaria y terciaria. Muchas de esas medidas no tienen un efecto comprobado de manera definitiva, dado que se realizan en un contexto controlado diferente a lo que ocurre en la vida real. Este documento tiene por objetivo revisar las evidencias más actuales sobre prevención de las enfermedades alérgicas considerando las certezas y cuestiones por resolver, y está especialmente centrado en las medidas ambientales, dietéticas, farmacológicas e inmunológicas para los distintos niveles preventivos. Es imperativo un mejor conocimiento de genes y factores ambientales responsables de las enfermedades alérgicas para optimizar las medidas preventivas que permitan revertir la creciente prevalencia de estas enfermedades en la infancia. Palabras clave: alergia, prevención, asma, control ambiental, inmunoterapia. ABSTRACTAllergic diseases have an increasing worldwide prevalence and a great impact on the health related costs. The research is focused on the study of etiological and risk factors of allergic diseases that can potentially be modified with primary, secondary and tertiary prevention strategies. Many of these measures do not have a definitively proven effect taking place in a controlled context different to what happens in real life. This paper aims to review the latest evidence on prevention of allergic diseases considering certainties and unresolved issues and focuses mainly on environmental, dietary, pharmacological and immunological preventive strategies for different levels of prevention. It is imperative to have a better understanding of genetic and environmental factors that cause allergic diseases to optimize preventive measures that are effective in reversing the increasing trend in the prevalence of allergic illnesses in childhood. Key words : allergy, prevention, asthma, environmental control, immunotherapy. http://dx.doi.org/10.5546/aap.2016.277 INTRODUCCIÓNL a s e n f e r m e d a d e s a l é r g i c a s constituyen las patologías crónicas más frecuentes en la edad pediátrica, c o n e l e v a d o s c o s t o s s a n i t a r i o s para el diagnóstico y tratamiento y afectación de la calidad de vida.1 . En Latinoamérica, aproximadamente el Comité Nacional de Alergia Documento de toma de posición Documento desarrollado en el marco del 50° aniversario del

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Preventive effects of sublingual immunotherapy in childhood: an open randomized controlled study

Cited by 218 publications

References 29 publications

Administration regimens for sublingual immunotherapy to pollen allergens: What do we know?

Administration regimens for sublingual immunotherapy to pollen allergens: What do we know?

Efficacy of allergen immunotherapy in reducing the likelihood of developing new allergen sensitizations: a systematic review

Prevención de las enfermedades alérgicas en la infancia: entre la teoría y la realidad

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