Efficacy of high-dose sublingual immunotherapy in children allergic to house dust mites in real-life clinical practice

Abstract

Background: The aim of the study was to evaluate the efficacy and safety of high-dose mite sublingual immunotherapy (SLIT) administered in children with allergic rhinitis in real-life clinical practice. Moreover, we analysed the clinical course of asthma severity.

Methods: Retrospective, observational, monocentre study. Medical records of patients treated between 2001 and 2008 were reviewed. Patients received a standardised Dermatophagoides pteronyssinus+Dermatophagoides farinae extract (300 IR/ml) manufactured by Stallergenes (Staloral(®) 300). Patients were evaluated before SLIT initiation and at 6, 12, 24, 36 and 48 months. Global assessment of SLIT efficacy was measured using a visual analogue scale (VAS) and a rhinitis medication consumption score (RMCS). A global asthma score was used to estimate the clinical course of asthma severity.

Results: We obtained data from 78 patients, 43.6% male. The mean (± SD) age was 11.0 ± 3.0 years. Most patients (69.2%) suffered from allergic rhinitis plus asthma. Patient evaluation of allergy severity (VAS) revealed a highly significant improvement between baseline and six months (p < 0.001, Wilcoxon test): 4.0 ± 1.7 cm vs. 7.3 ± 4.6 cm. This improvement was maintained throughout the four-year follow-up period. The use of medications (RMCS) was significantly reduced in the first six months (4.6 ± 2.5 points at baseline vs. 0.8 ± 1.6 points at six months visit, p < 0.001, Wilcoxon test) and remained very low until the end of follow-up. We did not find a temporal improvement in asthma severity.

Conclusions: This retrospective study indicates that high-dose SLIT in children with rhinitis caused by house dust mites is well-tolerated and could be an effective treatment.