Long-term effect of sublingual and subcutaneous immunotherapy in dust mite–allergic children with asthma/rhinitis: A 3-year prospective randomized controlled trial

Background and objective: specific allergen immunotherapy is the only treatment modality that might change the natural course of allergic diseases in childhood. we sought to prospectively compare the long-term clinical and immunological effects of sublingual (slit) and subcutaneous (scit) immunotherapy compared with pharmacotherapy alone. methods: in this single-center,prospective randomized controlled trial,48 children with mild persistent asthma with/without rhinitis,monosensitized to house dust mites (hdms) were followed for 3 years. at baseline and years 1 and 3 of follow-up,patients were evaluated and compared for total rhinitis (trss) and asthma (tass) symptom scores,total symptom scores (tss),total medication scores (tms),safety profiles,skin-nasal-bronchial reactivity,and immunological parameters. results: a significant reduction was observed in tass for both hdm-scit and hdm-slit at year 3 of treatment compared with baseline and controls (p<.05 for both),with significant improvement in rhinitis symptoms for both groups compared with controls (p=.01 for both). tss decreased significantly in both hdm-scit and hdm-slit at year 3 compared with baseline (p=.007 and p=.04,respectively) and controls (p<.01 for both). a significant reduction in tms was observed in hdm-scit and hdm-slit compared with baseline and controls (p=.01 in all cases),with a reduction in skin reactivity to hdm (p<.05). finally,a significant increase in allergen specific igg4 was observed in the scit group at year 3 compared with baseline,the slit group,and controls (p<.001 in all cases). conclusions: hdm-sensitized asthmatic children treated for at least 3 years with either scit or slit showed sustained clinical improvement. © 2015 esmon publicidad.