In 1993 the European Academy of Allergy and Clinical Immunology was the first
official organization to recognize that sublingual administration could be
?promising route? for allergic desensitization. A few years later, the World
Health Organization recommended this therapy as ?a viable alternative to the
injection route in adults.? The first meta-analysis showed sublingual
allergen specific immunotherapy (SLIT) effectiveness for allergic rhinitis
and another study showed SLIT can actually help prevent the development of
asthma both in adults and in children. The main goal of this review article
is to present insight into the most up-to-date understanding of the clinical
efficacy and safety of immunotherapy in the treatment of pediatric patients
with allergic rhinitis and asthma. A literature review was performed on
PubMed from 1990 to 2015 using the terms ?asthma,? ?allergic rhinitis,?
?children,? ?allergen specific immune therapy.? Evaluating data from
double-blind placebo-controlled randomized clinical trials (DB-PC-RCTs), the
clinical efficacy (assessed as the reduction of symptom score and the need of
rescue medicament) of SLIT for allergic rhinitis and allergic asthma, has
been confirmed in various meta-analysis Outcomes such as rhinoconjunctivitis
score and medication scores, combined scores, quality of life, days with
severe symptoms, immunological endpoints, and safety parameters were all
improved in the SLIT-tablet compared with placebo group. SLIT safety has been
already proven in many DB-PC-RCTs and real-life settings. In accordance with
all of the above mentioned, the goals for future trials and studies are the
development of comprehensive guidelines for clinical practice on
immunotherapy, embracing all the different potential participants. The
importance of allergen immunotherapy is of special relevance in the pediatric
age, when the plasticity and modulability of the immune system are maximal,
and when preventative effects can be reasonably expected.
Mite-Allergic Rhinitis: How to Evaluate Clinical Efficacy in Allergen-Specific Immunotherapy Trials?
