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[Immunotherapy with acarus extract in children under the age of 5 years]
M J Paniagua1, M Bosque, O Asensio
1Unidad de Alergia, Inmunología y Neumología Pediátrica, Hospital de Sabadell, Corporació Parc Taulí, Sabadell, Spain.
Insights
Specific immunotherapy for house dust mite allergy is safe and effective in children under 5 years old. This treatment can reduce asthma exacerbations and medication needs, even when started early.
Area of Science:
- Pediatric Allergy and Immunology
- Immunotherapy Research
- Respiratory Medicine
Background:
- Specific allergen immunotherapy is the only disease-modifying treatment for allergic diseases.
- World Health Organization guidelines suggest a relative contraindication for immunotherapy in children under 5 years old.
- Early initiation of immunotherapy may enhance treatment effectiveness.
Purpose of the Study:
- To assess the effectiveness and safety of specific immunotherapy in children under 5 years old.
- To evaluate clinical outcomes and tolerance in young children receiving house dust mite immunotherapy.
- To challenge existing contraindications for early-stage immunotherapy.
Main Methods:
- Retrospective review of clinical charts for 22 children with house dust mite asthma.
- Conventional subcutaneous immunotherapy using standardized extracts administered in a hospital setting.
- Evaluation of effectiveness and safety through clinical scores and reaction monitoring.
Main Results:
- Treatment duration averaged 16.95 months.
- Moderate systemic reactions occurred in 7 children, and local reactions in 5.
- Children treated for over a year showed reduced yearly acute exacerbations (5.13 to 2.57) and hospital admissions (5 to 2).
- 10 patients experienced a reduction in asthma medication requirements.
Conclusions:
- House dust mite specific immunotherapy is well-tolerated in young children under hospital supervision.
- Early immunotherapy initiation in children under 5 demonstrates clinical improvement.
- The findings support the use of immunotherapy in pre-school-aged children with allergic asthma.
Background:
Specific immunotherapy with allergens is the only treatment capacite of modifying the natural course of allergic diseases. Although its effectiveness is higher when started in early stages, WHO guidelines still consider age under 5 years as relative contraindication.A review of a group of 22 children starting immunotherapy before the age of 5 years in a pediatric allergy unit was attempted to assess the effectiveness and safety of this treatment.
Methodology And Results:
Clinical charts of 22 children with house dust mite asthma starting conventional immunotherapy before the age of 5 years were reviewed. In all cases, biologically standardized extracts and conventional subcutaneous schedules have been used and administration was performed in a hospital setting. Effectiveness and safety were evaluated by clinical scores. The average treatment period was 16.95 ( 10.12) months. Systemic reactions (moderate) were observed in 7 children and local reactions in 5. Children treated for more than 1 year (15 patients) showed a decrease in the number of yearly acute exacerbations (from 5.13 to 2.57) and in hospital admissions (from 5 to 2 children). In 10 patients, drug requirements for bronchial asthma were reduced.
Conclusion:
The clinical data if this study suggest that house dust mite specific immunotherapy under hospital control can be begun in young children with good tolerance and clinical improvement.