Side effects during subcutaneous immunotherapy in children with allergic diseases

2018 ◽  
Vol 29 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Max A. Tophof ◽  
Anne Hermanns ◽  
Thomas Adelt ◽  
Peter Eberle ◽  
Christine Gronke ◽  
...  
Keyword(s):  
Side Effects ◽  
Allergic Diseases ◽  
Subcutaneous Immunotherapy

scholarly journals Safety of house dust mite subcutaneous immunotherapy in preschool children with respiratory allergic diseases

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Yaqi Yang ◽  
Dongxia Ma ◽  
Nan Huang ◽  
Wenjing Li ◽  
Qing Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preschool Children ◽  
Side Effects ◽  
House Dust ◽  
House Dust Mite ◽  
Allergic Diseases ◽  
Subcutaneous Immunotherapy ◽  
Multivariable Logistic Regression Analysis ◽  
Causal Therapy ◽  
Dust Mite

Abstract Background Allergen immunotherapy (AIT) is the only causal therapy for IgE-mediated allergy. There is less evidence about the safety and efficacy of AIT especially subcutaneous immunotherapy (SCIT) in children under 5 years old. We aimed to investigate the side effects and associated risk factors of house dust mite (HDM) SCIT in preschool children with respiratory allergic diseases. Methods The preschool children who had HDM-related allergic rhinitis with/without asthma were enrolled and undergone standardized HDM SCIT in our department from June 2013 to December 2019. Local reactions (LRs) and systemic reactions (SRs) were recorded and categorized according to World Allergy Organization recommendations. Demographic data and other therapeutic-related parameters were also recorded to investigate potential risk factors for these side effects. Results A total of 91 children (60 boys, 65.93%; 31 girls, 34.07%; mean age 4.13 years old) were included in the study. Among the 91 patients, 3109 SCIT injections were recorded, 62/91 (68.13%) experienced 186 immediate LRs, 4 /91(4.40%) experienced 6 delayed LRs, 11/91 (12.09%) children experienced 44 immediate SRs, 21/44 (47.73%) were grade 1 SRs, 21/44 (47.73%) were grade 2, 2/44 (4.55%) were grade 3, no grade 4 or 5 SRs occurred. Furthermore, 1/91 (1.10%) experienced 1 delayed SRs, manifested by urticaria 2 days later after allergen injection. 9/91 (9.89%) experienced 2 or more times SRs. Multivariable logistic regression analysis showed BMI (OR 1.506; 95%CI 1.091 to 2.079; p < 0.05) and sIgE against HDM (OR 1.497; 95%CI 1.082 to 2.071; p < 0.05) were risk factors for LRs. No variable was found to correlate with SRs (all p > 0.05). Conclusions HDM subcutaneous immunotherapy is considered to be safe in preschool children with respiratory allergic diseases. Higher BMI and HDM sIgE level in children are risk factors for developing LRs. The incidence of SRs and the rate of severe SRs are low in preschool children.

Subkutane Allergen-Immuntherapie bei Hausstaubmilbenallergie – die Anwendung kann auch bei Kindern unter 5 Jahren sicher erfolgen

2021 ◽  
pp. 1-2
Author(s):  
Maximilian Jorczyk
Keyword(s):  
Risk Factors ◽  
Preschool Children ◽  
Side Effects ◽  
Demographic Data ◽  
Allergic Diseases ◽  
Subcutaneous Immunotherapy ◽  
Multivariable Logistic Regression Analysis ◽  
Causal Therapy ◽  
Potential Risk Factors ◽  
Associated Risk Factors

<b>Background:</b> Allergen immunotherapy (AIT) is the only causal therapy for IgE-mediated allergy. There is less evidence about the safety and efficacy of AIT especially subcutaneous immunotherapy (SCIT) in children under 5 years old. We aimed to investigate the side effects and associated risk factors of house dust mite (HDM) SCIT in preschool children with respiratory allergic diseases. <b>Methods:</b> The preschool children who had HDM-related allergic rhinitis with/without asthma were enrolled and undergone standardized HDM SCIT in our department from June 2013 to December 2019. Local reactions (LRs) and systemic reactions (SRs) were recorded and categorized according to World Allergy Organization recommendations. Demographic data and other therapeutic-related parameters were also recorded to investigate potential risk factors for these side effects. <b>Results:</b> A total of 91 children (60 boys, 65.93%; 31 girls, 34.07%; mean age 4.13 years old) were included in the study. Among the 91 patients, 3109 SCIT injections were recorded, 62/91 (68.13%) experienced 186 immediate LRs, 4 /91(4.40%) experienced 6 delayed LRs, 11/91 (12.09%) children experienced 44 immediate SRs, 21/44 (47.73%) were grade 1 SRs, 21/44 (47.73%) were grade 2, 2/44 (4.55%) were grade 3, no grade 4 or 5 SRs occurred. Furthermore, 1/91 (1.10%) experienced 1 delayed SRs, manifested by urticaria 2 days later after allergen injection. 9/91 (9.89%) experienced 2 or more times SRs. Multivariable logistic regression analysis showed BMI (OR 1.506; 95%CI 1.091 to 2.079; <i>p</i> &#x3c; 0.05) and sIgE against HDM (OR 1.497; 95%CI 1.082 to 2.071; <i>p</i> &#x3c; 0.05) were risk factors for LRs. No variable was found to correlate with SRs (all <i>p</i> &#x3e; 0.05). <b>Conclusions:</b> HDM subcutaneous immunotherapy is considered to be safe in preschool children with respiratory allergic diseases. Higher BMI and HDM sIgE level in children are risk factors for developing LRs. The incidence of SRs and the rate of severe SRs are low in preschool children.

scholarly journals Cost-effectiveness of allergic rhinitis treatment: An exploratory study

2018 ◽  
Vol 6 ◽  
pp. 205031211879458
Author(s):  
Jan Titulaer ◽  
Habibollah Arefian ◽  
Michael Hartmann ◽  
Mustafa Z Younis ◽  
Orlando Guntinas-Lichius
Keyword(s):  
Allergic Rhinitis ◽  
Cost Effectiveness ◽  
Side Effects ◽  
Symptom Score ◽  
Treatment Options ◽  
Local Therapy ◽  
Cost Effective ◽  
Subcutaneous Immunotherapy ◽  
Control Group ◽  
Placebo Control

Allergic rhinitis is serious public health problems and one of the most common chronic diseases worldwide. We aimed to assess the cost-effectiveness of clinically relevant treatment options for allergic rhinitis using evidence-based literature. In addition, we aimed to develop recommendations for allergic rhinitis treatment based on health economic facts. We searched MEDLINE via PubMed from 2009 to 2014 to identify all therapeutic options described in the current literature and selected randomized controlled trials that used a symptom score, had at least one placebo control group and used adult patients. We analyzed the side effects and the number of cases in which treatment was discontinued for each treatment option. Local antihistamines were the most cost-effective local therapy and are recommended due to the low number of complications. Regarding systemic therapies, although the use of oral steroids is indeed significantly cost-effective, this treatment was found to be associated with strong side effects. Sublingual immunotherapy was identified as the most cost-effective immunotherapy and exhibits a good side-effect profile. Overall, local therapy with antihistamines was found to be the most cost-effective option of all therapies. This study showed that there are only minor differences between sublingual and subcutaneous immunotherapy. Based on our results, we recommend the use of an international, uniform nasal symptom score to facilitate the comparison of clinical trials on allergic rhinitis in the future.

scholarly journals Metabolomics Reveals Process of Allergic Rhinitis Patients with Single- and Double-Species Mite Subcutaneous Immunotherapy

Metabolites ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 613
Author(s):  
Peiyan Zheng ◽  
Guanyu Yan ◽  
Yida Zhang ◽  
Huimin Huang ◽  
Wenting Luo ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Arachidonic Acid ◽  
Allergic Diseases ◽  
Subcutaneous Immunotherapy ◽  
Therapeutic Effects ◽  
Life Questionnaire ◽  
Potential Biomarker ◽  
Significant Difference ◽  
Acid Pathway ◽  
One Year

Allergen immunotherapy (AIT) is the only treatment that can change the course of allergic diseases. However, there has not been any research on metabolic reactions in relation to AIT with single or mixed allergens. In this study, patients with allergic rhinitis caused by Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) were treated with single-mite (Der p) and double-mite (Der p:Der f = 1:1) subcutaneous immunotherapy (SCIT), respectively. To compare the efficacy and the dynamic changes of inflammation-related single- and double-species mite subcutaneous immunotherapy (SM-SCIT and DM-SCIT), we performed visual analogue scale (VAS) score, rhinoconjunctivitis quality of life questionnaire (RQLQ) score and serum metabolomics in allergic rhinitis patients during SCIT. VAS and RQLQ score showed no significant difference in efficacy between the two treatments. A total of 57 metabolites were identified, among which downstream metabolites (5(S)-HETE (Hydroxyeicosatetraenoic acid), 8(S)-HETE, 11(S)-HETE, 15(S)-HETE and 11-hydro TXB2) in the ω-6-related arachidonic acid and linoleic acid pathway showed significant differences after approximately one year of treatment in SM-SCIT or DM-SCIT, and the changes of the above serum metabolic components were correlated with the magnitude of RQLQ improvement, respectively. Notably, 11(S)-HETE decreased more with SM-SCIT, and thus it could be used as a potential biomarker to distinguish the two treatment schemes. Both SM-SCIT and DM-SCIT have therapeutic effects on patients with allergic rhinitis, but there is no significant difference in efficacy between them. The reduction of inflammation-related metabolites proved the therapeutic effect, and potential biomarkers (arachidonic acid and its downstream metabolites) may distinguish the options of SCIT.

scholarly journals Preparation and Characterization of a Glycyrrhizic Acid-Based Drug Delivery System for Allergen-Specific Immunotherapy

2021 ◽  
Author(s):  
Ekaterina Pashkina ◽  
Veronika Evseenko ◽  
Natalya Dumchenko ◽  
Maxim Zelikman ◽  
Alina Aktanova ◽  
...  
Keyword(s):  
Side Effects ◽  
Delivery System ◽  
Glycyrrhizic Acid ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Treg Cells ◽  
Delivery Systems ◽  
New Drugs ◽  
Allergen Specific Immunotherapy

The most effective method of treating allergic diseases, aimed not at relieving symptoms, but at eliminating the cause of the disease, is allergen-specific immunotherapy (AIT). To reduce the risk of side effects and improve the delivery of allergens to the mucosa, various delivery systems, such as liposomes, dendrimers, nanoparticles, etc., can be used. To date, there are data on the creation of delivery systems based on glycyrrhizic acid (GA) and its derivatives, but such a delivery system has not been used for allergen-specific therapy until now. At the same time, it is known that GA has an anti-inflammatory effect, shifts the balance towards Th1, and increases the number of Treg cells, which means that in the future it can enhance the anti-allergic effect of AIT and reduce the risk of unwanted side effects. Thus, the study of the immunomodulatory effect of supramolecular complexes (micelles) of GA with extracts of allergens seems to be very promising for the development of new drugs for AIT.

scholarly journals Standardized Quantitative Evaluation of Clinical Effectiveness and Side Effect Profile of Subcutaneous and Sublingual Allergen-Specific Immunotherapy in Children: A 5-Year Single Center Experience

2021 ◽  
Vol 19 (3) ◽  
pp. 156-165
Author(s):  
Nazan TÖKMECI ◽  
Ali DEMIRHAN ◽  
Merve TURKEGUN SENGUL ◽  
Burcu CAGLAR YUKSEK ◽  
Aylin KONT ÖZHAN ◽  
...  
Keyword(s):  
Side Effects ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Visual Analog Score ◽  
Allergen Specific Immunotherapy ◽  
Medication Score ◽  
Asthma Patients ◽  
Systemic Side Effects ◽  
High Responders

Objective: Allergen-specific immunotherapy (allergen-SIT) is a treatment method with variable efficacy in allergic diseases. This study aimed to investigate the effectiveness of allergen immunotherapy, frequency of LRs and SRs and variables affecting these parameters in patients who underwent allergen-SIT. Materials and Methods: In this study, the recorded data of 81 patients, who received subcutaneous (SCIT) or sublingual (SLIT) allergen immunotherapy for respiratory allergic diseases between 2014 and 2019, were analyzed. In asthma and/or allergic rhinoconjunctivitis (ARC) patients, the effectiveness of treatment was evaluated by analysing the change rates in disease symptom, medication and combined scores (symptom + medication) and visual analog score (VAS). Treatment success was defined by the degree of decrease in scores as; high response above 50%; low response between 20-50%; and failure <20%.Results: The mean age of allergen-SIT initiation was 11.4± 3.1 years. Diagnostic distributions of the patients were asthma (± ARC) in 64.2%, and ARC (without asthma) in 35.8%. The mode of allergen-SIT was SCIT in 77.8% (65% asthma and 35% ARC) and SLIT in 22.2% (61.1% asthma and 38.9% ARC). The main allergens used in allergen-SIT were mite (79%), grass-grain pollen (33.3%), alternaria (9.9%) and olea (8.6%). There was a significant decrease in symptoms, medication, combined and VAS scores in the asthma and ARC groups (p <0.0001), when end-SCIT values were compared to baseline. SLIT also resulted in significant decreases in these scores except asthma medication score. Among the asthma patients the rate of high-responders was 88.8% by SCIT and 50% by SLIT, according to combined asthma score. Among the ARC (without asthma) patients the rate of high-responders was 100% for both SCIT and SLIT. SCIT resulted in local (LR) and systemic side effects (SR) in 18% and 0.6% (all Grade I and Grade II) of the total injections performed. A high number of total injections was significantly associated with higher LR and SR rates. While LR was observed in 16.6% of the patients who underwent SLIT, no systemic reaction was found in any of the patients. Conclusion: SCIT was highly successful in the treatment of asthma and ARC in terms of the degree of therapeutic response. SLIT resulted in a high rate of good response in ARC patients, but a lower response degree in asthmatic patients. Systemic side effects were very low as a result of close risk monitoring and the dose adjustments performed. Keywords: Allergen-specific immunotherapy, SCIT, SLIT, efficacy, symptom score, medication score, visual analog score, side effects

scholarly journals Allergen-specific subcutaneous immunotherapy–pain evaluation in pediatric age

2021 ◽  
Vol 49 (1) ◽  
pp. 58-61
Author(s):  
Christiana Ferreira ◽  
Isabel Rezende ◽  
Arminda Guilherme ◽  
Inês Lopes
Keyword(s):  
Scale Score ◽  
Adverse Reactions ◽  
Pediatric Patients ◽  
Allergic Diseases ◽  
Subcutaneous Immunotherapy ◽  
Allergen Specific Immunotherapy ◽  
Pain Evaluation ◽  
Pain Scores ◽  
Maximum Pain ◽  
Numeric Scale

Background: Allergen-specific immunotherapy is a potentially disease-modifying therapy that is effective for the treatment of patients with allergic diseases. Although the pain caused by the administration of subcutaneous immunotherapy with allergens (SCITA) is considered to be minimal, no studies assessing that pain for the treatment of only pediatric patients have been reported. Objectives: This research aimed to evaluate the pain associated with SCITA for pediatric patients followed at our Immunoallergology Department. Methods: During four consecutive weeks, the nurse who administered the injection completed a questionnaire recording the child’s assessment of the pain associated with SCITA; these questionnaires were randomized before any analyses were done. Two different pain evaluation scales were used, with the choice of scale being determined based on the child’s age: the self-reporting faces scale (score: 0–10; 5 to 8 years old) and the numeric scale (score: 0–10; >8 years old). Demographic and clinical data, as well as any adverse reactions, were documented. Results: We included 46 pediatric patients (mean age: 12.3 ± 2.6 years; 69.5% male), most of whom were suffering from rhinitis/rhinoconjunctivitis and undergoing subcutaneous immunotherapy with mites. Seven local adverse reactions were recorded, and all were mild. Ten patients did not mention any pain associated with SCITA. Of the 36 patients who mentioned some pain, 33 mentioned mild pain (scores between 1 and 3); only three mentioned moderate pain (scores between 4 and 6). For both scales, the median score obtained was 1. The maximum pain reported had a score of 6. No significant differences were observed between different groups of patients. Conclusions: In this study, SCITA was shown to be a mildly painful procedure that is associated with only a few local reactions. Therefore, SCITA should be considered as a safe option for the treatment of most pediatric patients suffering from allergies.

scholarly journals A kortikoszteroidtartalmú szemcseppek alkalmazása gyermekkori allergiás szembetegségek kezelésében

2019 ◽  
Vol 160 (9) ◽  
pp. 329-337 ◽  
Author(s):  
Anita Csorba ◽  
Anna Soproni ◽  
Otto Maneschg ◽  
Zoltán Zsolt Nagy ◽  
Anna Szamosi
Keyword(s):  
Side Effects ◽  
Allergic Conjunctivitis ◽  
Vision Loss ◽  
Treatment Options ◽  
Allergic Diseases ◽  
Eye Diseases ◽  
Vernal Keratoconjunctivitis ◽  
Inappropriate Therapy ◽  
Dual Action ◽  
Giant Papillary Conjunctivitis

Abstract: The prevalence of allergic diseases has been increasing recently. Allergy has various symptoms. Allergic eye diseases (seasonal and perennial allergic conjunctivitis, vernal keratoconjunctivitis, atopic keratoconjunctivitis, giant papillary conjunctivitis, contact blepharoconjunctivitis) are common in atopic patients. Treatment options for allergic conjunctivitis include local and systemic antihistamines, mast cell stabilizers, dual-action agents, vasoconstrictors and corticosteroids. Treatment seems easy, but inappropriate therapy – in extreme cases – can lead to vision loss. Corticosteroid eyedrops provide effective relief of symptoms, however, their use is limited due to their severe side effects. Both steroid-induced cataract and steroid-induced glaucoma are dangerous for vision. The characteristics, frequency and risks of these side effects have been studied widely in adults, but there are very few studies focused on children. According to the present studies, the side effects of topically administered corticosteroids appear more often in children than in adults. Orv Hetil. 2019; 160(9): 329–337.

The local and systemic side-effects of venom and inhaled-allergen subcutaneous immunotherapy

2009 ◽  
Vol 121 (9-10) ◽  
pp. 357-360 ◽  
Author(s):  
Katja Adamic ◽  
Mihaela Zidarn ◽  
Nissera Bajrovic ◽  
Renato Erzen ◽  
Peter Kopac ◽  
...  
Keyword(s):  
Side Effects ◽  
Subcutaneous Immunotherapy ◽  
Systemic Side Effects
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