Related Experiment Video
Updated: Jul 4, 2025
Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Effectiveness of sublingual immunotherapy in pediatric cedar pollinosis: A real-world database study
Rie Matsushita1, Sachiko Tanaka-Mizuno1,2, Masato Takeuchi1
1Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Insights
Sublingual immunotherapy (SLIT) effectively reduced medication use in children with cedar pollinosis (CP) over three years. SLIT also lowered the risk of adverse events and other allergic conditions in this pediatric population.
Area of Science:
- Pediatric Allergy and Immunology
- Immunotherapy Research
- Real-world Evidence in Healthcare
Background:
- Pediatric allergic rhinitis (AR), particularly cedar pollinosis (CP), is a growing health concern in Japan.
- Limited real-world data exists on the effectiveness of sublingual immunotherapy (SLIT) for pediatric CP.
Purpose of the Study:
- To evaluate the real-world effectiveness and safety of SLIT in children diagnosed with CP.
- To assess the impact of SLIT on medication scores and the incidence of other allergic diseases.
Main Methods:
- Retrospective cohort study utilizing a healthcare claims database from 2018-2021.
- Included 2962 children with CP undergoing SLIT and 547 controls (≤15 years).
- Medication scores, adverse events, and new allergic disease occurrences were analyzed during cedar pollen seasons.
Main Results:
- The SLIT group showed a significantly lower medication score in 2021 compared to the non-SLIT group (adjusted mean difference -0.62, p < .0001).
- SLIT was associated with reduced risk of adverse events including abdominal disorders (aOR 0.64) and asthma exacerbation (aOR 0.37).
- Lower incidence of unrelated hay fever (aOR 0.60) and asthma (aOR 0.71) was observed in children receiving SLIT.
Conclusions:
- Sublingual immunotherapy is an effective and well-tolerated treatment for pediatric cedar pollinosis in a real-world setting.
- SLIT may help prevent the development of other allergic conditions, such as asthma and unrelated allergic rhinitis.
- Findings support the use of SLIT as a valuable therapeutic option for managing pediatric CP.
Background:
Pediatric allergic rhinitis (AR), including cedar pollinosis (CP), is increasing in Japan. We investigated the effects of sublingual immunotherapy (SLIT), which has limited studies of its effectiveness in real-world settings, on children with CP.
Methods:
This retrospective cohort study used a claim database in 2018-2021. Children aged ≤15 years with CP records in 2019 were eligible and were followed up through 2021. We included 2962 CP children undergoing SLIT and 547 who were not. The medication score was used to evaluate SLIT effectiveness in the cedar pollen dispersal season each year. Adverse events and the occurrence of allergic diseases were also evaluated.
Results:
Medication score was higher in the SLIT group during the index period but lower in 2021 compared to the non-SLIT group (mean ± standard deviation: 5.17 ± 2.39 and 4.74 ± 2.38 in 2019, 3.13 ± 2.30 and 3.55 ± 2.48 in 2021, respectively). The adjusted mean difference between groups from 2019 to 2021 was -0.62 (95% confidence interval: -0.86 to -0.39, p < .0001), and the medication score was reduced in the SLIT group (risk ratio: 1.2: 1.1 to 1.3). The occurrence of adverse events involving abdominal disorders (adjusted odds ratio [aOR]: 0.64: 0.51 to 0.81), asthma exacerbation (aOR: 0.37: 0.24 to 0.57), and allergic diseases involving hay fever unrelated to CP (aOR: 0.60: 0.45 to 0.80) or asthma (aOR: 0.71: 0.58 to 0.86) was lower in the SLIT group.
Conclusion:
In children with CP, SLIT is effective, well tolerated, and could decrease the occurrence of other allergic diseases.
