Sublingual immunotherapy in pediatric patients: beyond clinical efficacy

Baena-Cagnani, Carlos E.; Passalacqua, Giovanni; Baena-Cagnani, Rodrigo; Croce, V.H.; Canonica, Giorgio Walter

doi:10.1097/01.all.0000162311.87178.9e

Cited by 17 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are some preliminary studies on SLIT in preschool children (1721,2241). It has been found to be safe but its efficacy needs to be tested further.…”

Section: Aria: 2008 Updatementioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,867

1,761

View full text Add to dashboard Cite

“…There are some preliminary studies on SLIT in preschool children (1721,2241). It has been found to be safe but its efficacy needs to be tested further.…”

Section: Aria: 2008 Updatementioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,867

1,761

View full text Add to dashboard Cite

“…Specific immunotherapy (SIT) is a recognized method of treating IgE‐mediated allergies, particularly allergic rhinitis in paediatric patients (7–15). Although data may be insufficient to draw firm conclusions (16) in some studies the clinical outcome of SIT for the treatment of allergic rhinitis appears to be greater in children than in adults (17).…”

Section: Efficacy Of Slit In Childrenmentioning

confidence: 99%

Sublingual immunotherapy in the treatment of children

Pham‐Thi

Blic

Scheinmann

2006

Allergy

View full text Add to dashboard Cite

Children with controlled intermittent mild‐to‐moderate asthma, controlled rhinitis and a single sensitivity may be appropriate candidates for sublingual immunotherapy (SLIT). Positive effects of SLIT may depend on initiation in early childhood and a long duration of treatment. To ensure optimum compliance, sociological, economic and familial factors should also be taken in to consideration when prescribing SLIT. Evidence from recent long‐term trials indicates that SLIT interfered with the atopic march and the allergic progression from rhinitis to asthma without any severe adverse side effects. Local immune response has been seen to be blunted with SLIT, which suggests that treatment has an immunomodulatory effect. In addition, it may also decrease the risk of new sensitizations. Ongoing developments in SLIT, particularly advances in dosing and new indications, such as food allergies, will increase the use of this treatment modality in children.

show abstract

“…Unlike immunotherapy where immune tolerance, and hence symptom relief, persists well beyond completion of the treatment program, in SOTI, regular exposure is necessary to maintain immune modulation 23. This may be stressful to the child and his or her family as omission of the daily dose of milk can lead to recurrence of symptoms 24.…”

Section: Introductionmentioning

confidence: 99%

Implementing specific oral tolerance induction to milk into routine clinical practice: experience from first 50 patients

Luyt¹,

Bravin²,

Luyt³

2014

JAA

View full text Add to dashboard Cite

BackgroundAlthough the natural history of cow’s milk allergy is to resolve during childhood or adolescence, a small but significant proportion of children will remain allergic. Specific oral tolerance induction to cow’s milk (CM-SOTI) provides a treatment option in these children with continuing allergy with high success rates. However current sentiment limits widespread availability as existing reports advise that it is too soon to translate CM-SOTI into routine clinical practice.MethodsIn January 2007 we implemented a slow up-dosing CM-SOTI program. Eligible subjects were identified at routine visits to our children’s allergy clinic. Persisting cow’s milk allergy was confirmed from recent contact symptoms or a positive baked milk challenge. As allergic symptoms are common during CM-SOTI, families were provided with ready dietetic access for advice on dosing and symptom treatment. Subjects were continuously monitored at subsequent clinic visits or telephonically, where no longer followed, for a median of 49 months.ResultsThe first 50 subjects (35 males) treated ranged in age from 5.1 to 15.8 years (median 10.3 years). Full tolerance (250 mL) was achieved in 23 subjects, 9 without any symptoms, and a further 9 achieved partial tolerance with continued ingestion. Eighteen children failed to achieve any regular milk ingestion; 11 because of persistent or significant symptoms whilst 8 withdrew against medical advice. Allergic symptoms were predominantly mild to moderate in severity, although 2 cases needed treatment with inhaled salbutamol and a further 2 required intramuscular adrenaline. Clinical tolerance, both full and partial, persists beyond 5 years.ConclusionWe have demonstrated that a CM-SOTI program can be successfully and safely implemented as routine clinical practice with acceptable compliance during prolonged home up-dosing, despite frequent allergic symptoms, and for up to 4 years after starting treatment. CM-SOTI can thus be put into practice more widely where there is appropriate support.

show abstract

Sublingual immunotherapy in pediatric patients: beyond clinical efficacy

Abstract: Due to its excellent safety, SLIT would be an optimal candidate for use in pediatric age groups, where the natural history of allergy can be to some extent modified. Nonetheless, formal and rigorous studies are needed to define its exact indication and dosage.

Cited by 17 publications

References 31 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Sublingual immunotherapy in the treatment of children

Implementing specific oral tolerance induction to milk into routine clinical practice: experience from first 50 patients

Contact Info

Product

Resources

About