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Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Early and longitudinal response to sublingual immunotherapy across pediatric allergic multimorbidity patterns: A
Victor Gonzalez-Uribe1,2, Jimena Prieto-Gomez1,2, Sebastian Moreno-Castro1,2
1AlergiaMx, Mexico City, Mexico.
Insights
Pediatric sublingual immunotherapy (SLIT) shows varied early responses based on allergic multimorbidity. Asthma plus allergic rhinitis patients responded best, while those with atopic dermatitis showed lower response rates.
Area of Science:
- Pediatric Allergy and Immunology
- Immunotherapy Research
- Clinical Outcomes
Background:
- Uncertainty exists regarding the timing of clinically significant benefits from pediatric sublingual immunotherapy (SLIT) across diverse allergic multimorbidity patterns.
- Evaluating early and long-term responses to SLIT in real-world clinical settings is crucial.
Purpose of the Study:
- To assess the early and longitudinal effectiveness of sublingual immunotherapy (SLIT) in children with allergic multimorbidity.
- To identify differences in SLIT response based on specific allergic conditions.
Main Methods:
- Retrospective longitudinal cohort study of 1208 patients aged 3-17 years receiving individualized liquid-drop SLIT.
- Data collected at baseline and 6, 12, 18, 24, and 36 months.
- Primary outcome: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) minimal clinically important difference (MCID) at 6 months.
Main Results:
- 60.8% of patients achieved the PAQLQ MCID at 6 months.
- Highest response rates observed in patients with asthma plus allergic rhinitis (76.8%), lowest in those with asthma, AR, and atopic dermatitis (28.2%).
- Significant improvements in PAQLQ, rhinitis quality of life, FeNO, and reduced inhaled corticosteroid use by 36 months.
Conclusions:
- Early response to pediatric SLIT is influenced by allergic multimorbidity patterns.
- Outcomes continue to improve up to 36 months in adherent and persistent patients.
- SLIT demonstrates potential for long-term benefit in pediatric allergic diseases.
Background:
The timing of clinically meaningful benefit after pediatric sublingual immunotherapy (SLIT) across allergic multimorbidity patterns remains uncertain. We evaluated early and longitudinal response to SLIT in routine care.
Methods:
This retrospective longitudinal cohort included patients aged 3-17 years who received individualized liquid-drop SLIT and met prespecified adherence and treatment-persistence criteria. Assessments were performed at baseline and months 6, 12, 18, 24, and 36. The primary outcome was achievement of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) minimal clinically important difference (MCID; increase ≥0.5 points) at month 6.
Results:
Among 1208 patients, 1095 had asthma and 954 allergic rhinitis. Overall, 666/1095 (60.8%) achieved month-6 PAQLQ MCID: 515/671 (76.8%) with asthma plus allergic rhinitis (Asthma+AR), 103/254 (40.6%) with allergic asthma without AR, and 48/170 (28.2%) with asthma, AR, and atopic dermatitis (Asthma+AR + AD). Compared with allergic asthma without AR, adjusted odds of response were higher for Asthma+AR (adjusted odds ratio 4.73, 95% CI 3.47-6.45) and lower for Asthma+AR + AD (0.52, 95% CI 0.34-0.80). By month 36, mean PAQLQ increased by 1.42 points, rhinitis-related quality-of-life scores decreased by 1.89 points, FeNO decreased by 15.7 ppb, and prescribed inhaled corticosteroid dose decreased by 92.6%.
Conclusion:
Early response to pediatric SLIT differed across clinical allergic multimorbidity patterns, although outcomes continued to improve through 36 months in this selected adherent and treatment-persistent cohort.
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