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Pediatr Allergy Immunol. 2017 Feb;28(1):60-70. doi: 10.1111/pai.12660. Epub 2016 Nov 3.

The European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): A paediatric assessment.

Author information

1
Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
2
Allergy Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
3
Centre de l'Asthme et des Allergies, Hôpital d'enfant Armand Trousseau, Paris, France.
4
Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Spain.
5
Allergy Department, Hospital de Ofra, Santa Cruz de Tenerife, Spain.
6
Private Office, Kassel, Germany.
7
Allergy Section, Hospital General Universitario, Ciudad Real, Spain.
8
Ear, Nose and Throat Practice, Lutherstadt, Eisleben, Germany.
9
Center for Rhinology and Allergology, Wiesbaden, Germany.
10
Department of Otorhinolaryngology and Head and Neck Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
11
Département de Pneumologie et Addictologie, UMR-S 1136, IPLESP, Equipe EPAR, Hôpital Arnaud de Villeneuve, UPMC Paris 06, University Hospital of Montpellier, Sorbonne Universités, Paris, France.
12
Imperial College-National Heart and Lung Institute, London, UK.

Abstract

BACKGROUND:

Safety data on 'real-life' allergen immunotherapy (AIT) in children and adolescents is usually extrapolated from studies in adults.

METHODS:

Patients aged 18 or under initiating aeroallergen AIT were evaluated in a prospective European survey. Patient profiles and systemic reactions (SRs) were recorded. Descriptive, univariate and multivariate analyses were used to identify risk factors for SRs.

RESULTS:

A total of 1563 patients (mean ± SD age: 11.7 ± 3.9 years; rhinitis: 93.7%; asthma: 61.5%; polysensitization: 62.5%) and 1578 courses of AIT were assessed. Single-allergen AIT was administered in 89.5% of cases (n = 1412; mites: 49%; grass pollen: 25.8%; tree pollen: 8.7%; Alternaria: 4.6%; dander: 0.8%; weed pollen: 0.6%). Subcutaneous AIT (SCIT) was used in 71.4% (n = 1127) of the treatments, including 574 (50.9%) with natural extracts. Sublingual AIT (SLIT) was used for the remaining 451 treatments (drops: 73.8%; tablets: 26.2%). The mean ± SD follow-up period was 12.9 ± 3.3 months. The estimated total number of doses was 19,669 for SCIT and 131,550 for SLIT. Twenty-four patients (1.53%) experienced 29 SRs. Respiratory (55.7%) and skin symptoms (37.9%) were most frequent. Anaphylaxis was diagnosed in 3 SRs (10.3%), and adrenaline was administered in 2 of these cases. In a univariate analysis, the risk of SRs was lower in mite-sensitized patients and higher in cases of pollen polysensitization (>3), grass pollen extracts and the use of natural extracts (vs. allergoids).

CONCLUSIONS:

In a real-life paediatric setting, AIT is safe. SRs are infrequent and generally not severe. Pollen polysensitization, grass pollen extracts and natural extracts (vs. allergoids) were risk factors for AIT-associated SRs.

KEYWORDS:

Medical Dictionary for Regulatory Activities; adrenaline; allergen immunotherapy; anaphylaxis; children; risk factor; subcutaneous; sublingual; systemic reaction

PMID:
27637414
DOI:
10.1111/pai.12660
[Indexed for MEDLINE]

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