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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
11/1/06
Sublingual immunotherapy in children
Summary
Background - There has been an increasing interest in and use of sublingual allergy immunotherapy (SLIT), particularly in Europe. Is SLIT effective and safe in children?
Findings - Penagos et al of the Univ of Genoa carried out a meta-analysis of randomized, placebo-controlled, double blind trials of SLIT in allergic rhinitis (AR) in subjects 3-18 years old. In 484 patients evaluated in 10 studies meeting selection criteria a sizable heterogeneity in findings due to variable scoring systems was noted. Overall, following SLIT there was a significant reduction in mean daily symptoms (0.56; p=0.02) and a less impressive reduction in medication use (0.76; p=0.03, confidence interval 1.46-0.06) following active SLIT vs placebo. SLIT was more effective when carried out for more than 18 months and using pollen extracts when compared to SLIT for shorter time periods and using mite extracts.
Reference
Ann Allergy Asthma Immunol 2006;97:141-8
Editor's Comments
There appears to be little question that SLIT using pollen extracts confers moderate, significant benefit in seasonal AR in adults. The findings described above indicate such efficacy of SLIT in children/adolescents. Whether SLIT is as effective as traditional sub-cutaneous IT and whether SLIT is effective in perennial AR and asthma are still uncertain. A recent development in SLIT has been the use of pollen tablets which dissolve rapidly in the mouth (JACI 2006;118:434-40). A major advantage of SLIT is the very low incidence of systemic adverse reactions. Local (oral) adverse effects do occur commonly but are not serious.
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