Preventive effects of sublingual immunotherapy in childhood: an open randomized controlled study

被引:181
作者
Marogna, Maurizio [2 ]
Tomassetti, Dante [2 ]
Bernasconi, Antonella [2 ]
Colombo, Fausto [2 ]
Massolo, Alessandro [3 ]
Businco, Andrea Di Rienzo [4 ]
Canonica, Giorgio W. [1 ]
Passalacqua, Giovanni [1 ]
Tripodi, Salvatore [4 ]
机构
[1] Univ Genoa, Dept Internal Med, I-16132 Genoa, Italy
[2] Macchi Hosp Fdn, Pneumol Unit, Varese, Italy
[3] Univ Pavia, Dept Anim Biol, I-27100 Pavia, Italy
[4] S Pertini Hosp, Pediat Allergy Unit, Rome, Italy
关键词
D O I
10.1016/S1081-1206(10)60211-6
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Sublingual immunotherapy (SLIT) has been proved to be effective in allergic rhinitis and asthma, but there are few data on its preventive effects, especially in children. Objective: To evaluate the clinical and preventive effects of SLIT in children by assessing onset of persistent asthma and new sensitizations, clinical symptoms, and bronchial hyperreactivity. Methods: A total of 216 children with allergic rhinitis, with or without intermittent asthma, were evaluated and then randomized to receive drugs alone or drugs plus SLIT openly for 3 years. The clinical score was assessed yearly during allergen exposure. Pulmonary function testing, methacholine challenge, and skin prick testing were performed at the beginning and end of the study. Results: One hundred forty-four children received SLIT and 72 received drugs only. Dropouts were 9.7% in the SLIT group and 8.3% in the controls. New sensitizations appeared in 34.8% of controls and in 3.1% of SLIT patients (odds ratio, 16.85; 95% confidence interval, 5.73-49.13). Mild persistent asthma was less frequent in SLIT patients (odds ratio, 0.04; 95% confidence interval, 0.01-0.17). There was a significant decrease in clinical scores in the SLIT group vs the control group since the first year. The number of children with a positive methacholine challenge result decreased significantly after 3 years only in the SLIT group. Adherence was 80% or higher in 73.8% of patients. Only 1 patient reported systemic itching. Conclusions: In everyday clinical practice, SLIT reduced the onset of new sensitizations and mild persistent asthma and decreased bronchial hyperreactivity in children with respiratory allergy.
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页码:206 / 211
页数:6
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