Safety of allergen‐specific immunotherapy in children

Allergic respiratory diseases, such as asthma and allergic rhinitis, are global health issues and have had an increasing prevalence in the last decades. Allergen‐specific immunotherapy (AIT) is the only curative treatment for allergic rhinitis and asthma, as it has a disease‐modifying effect. AIT is generally administered by two routes: subcutaneous (SCIT) and sublingual immunotherapy (SLIT). Local side effects are common, but usually well‐tolerated and self‐limited. However, systemic side effects are rare, and associated with uncontrolled asthma and bronchial obstruction, or related to errors in administration. Physicians should constantly assess potential risk factors for not only reporting systemic reactions and fatalities but also implementing other therapies to improve AIT safety. This paper highlights recent evidence on local and systemic reactions related to SCIT and SLIT in children.

[1]  V. Delian.  Efficacy and safety of allergen-specific immunotherapy in children , 2022, Kazan medical journal.

[2]  G. Canonica,et al.  Personalized medicine and allergen immunotherapy: the beginning of a new era? , 2021, Clinical and Molecular Allergy.

[3]  R. Mösges,et al.  Worldwide surveys on anaphylaxis to sublingual immunotherapy with house dust mite tablets are urgently needed , 2021, Clinical and translational allergy.

[4]  G. Ciprandi,et al.  Eosinophilic gastrointestinal disorders and allergen immunotherapy: Lights and shadows , 2021, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[5]  C. Caffarelli,et al.  Safety, Efficacy, and Preventive Role of Subcutaneous and Sublingual Allergen Immunotherapy for the Treatment of Pediatric Asthma , 2020, Journal of asthma and allergy.

[6]  G. Ciprandi,et al.  Allergen immunotherapy in atopic dermatitis: Light and shadow in children , 2020, Pediatric Allergy and Immunology.

[7]  S. Rizzi,et al.  Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic , 2020, Italian Journal of Pediatrics.

[8]  D. Bernstein,et al.  Safety of allergen immunotherapy in North America from 2008-2017: Lessons learned from the ACAAI/AAAAI National Surveillance Study of adverse reactions to allergen immunotherapy. , 2020, Allergy and asthma proceedings.

[9]  A. Sheikh,et al.  2019 ARIA Care pathways for allergen immunotherapy , 2019, Allergy.

[10]  D. Har,et al.  Systemic reaction rates with omalizumab, subcutaneous immunotherapy, and combination therapy in children with allergic asthma. , 2019, Allergy and asthma proceedings.

[11]  A. Licari,et al.  Biomarkers of immunotherapy response in patients with allergic rhinitis , 2018, Expert review of clinical immunology.

[12]  A. Bufe,et al.  Side effects during subcutaneous immunotherapy in children with allergic diseases , 2018, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[13]  D. Bernstein,et al.  Pooled efficacy and safety data for house dust mite sublingual immunotherapy tablets in adolescents , 2017, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[14]  J. Sastre,et al.  Adverse reactions to immunotherapy are associated with different patterns of sensitization to grass allergens , 2015, Allergy.

[15]  Murugappan Ramanathan,et al.  Sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review. , 2013, JAMA.

[16]  G. Passalacqua,et al.  A prospective Italian survey on the safety of subcutaneous immunotherapy for respiratory allergy , 2009, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[17]  P. Kuna,et al.  Efficacy and safety of 5-grass-pollen sublingual immunotherapy tablets in pediatric allergic rhinoconjunctivitis. , 2009, The Journal of allergy and clinical immunology.