Symptom and quality of life assessment during season undergoing pollen immunotherapy: single center study

Allergic rhinitis (AR) is an IgE-mediated inflammatory condition of the nasal mucosa. Allergen immunotherapy (AIT) is the only treatment that can modify disease progression and provide long-term symptom control. This study evaluated symptom burden and health-related quality of life (HRQoL) during the pollen season in pediatric patients treated with subcutaneous pollen immunotherapy (SCIT).

This prospective, cross-sectional study included children aged 6-18 years who received ≥12 months of AIT between 2014 and 2022. All had isolated pollen allergy and were treated with SCIT. Symptom control was assessed using the Total Nasal Symptom Score (TNSS) and Visual Analog Scale (VAS), while HRQoL was measured using PRQLQ or RQLQ depending on age. Patients were grouped by treatment duration: <36 months and ≥36 months.

Forty-seven patients completed questionnaires at least two pollen seasons after their final SCIT dose. Compared with the <36-month group, patients treated for ≥36 months showed significantly lower nasal and ocular symptoms (P < 0.001). Mean TNSS scores were lower (5.42 vs. 9.57, P = 0.018), and more patients had mild symptoms (60.6% vs. 21.4%, P = 0.003). Good symptom control (VAS < 2) was also more frequent (36.4% vs. 14.3%, P = 0.022). HRQoL scores (PRQLQ/RQLQ) were significantly better in the ≥36-month group, particularly in social and school functioning.

SCIT duration ≥36 months is associated with improved symptom control and HRQoL during the pollen season, supporting guideline recommendations of at least 3 years of AIT in pediatric AR.