A NEW study shows that allergy immunotherapy may offer relief for young children with allergic rhinitis while also reducing asthma risks. The research led by Koki Sasamoto, Sagamihara National Hospital, Japan, examined the efficacy and safety of house dust mite (HDM) sublingual immunotherapy (SLIT) tablets for children aged 1 to 4 years with perennial allergic rhinitis (AR).
The study involved 34 children, with 22 in the treatment group receiving daily SLIT doses of 10,000 Japanese allergy units (JAU) for 12 months, while 12 children in the control group received only symptomatic treatment. The median age of participants was 41 months in the SLIT group and 34 months in the control group and both groups had a baseline allergic rhinitis symptom score of 4.
After 12 months, children in the SLIT group experienced a significant reduction in their allergic rhinitis symptom score, dropping from 4 to 3 (P = .002). In contrast, the control group’s symptom score increased to 6, although this change was not statistically significant (P = .08). The treatment group also showed improvements in medication use and sleep disorder scores.
Immunologically, the SLIT group exhibited a temporary rise in Dermatophagoides farinae-specific IgE levels during the first six months, which then returned to baseline by the end of the study. In contrast, the control group saw a significant increase in IgE levels at 12 months (P = .01). Additionally, the SLIT group had a significant increase in specific IgG4 and IgE-blocking factors at 12 months, underscoring SLIT’s immunomodulatory effects.
Adverse reactions were mild, affecting 36% of the treatment group, with symptoms such as oral discomfort and pruritis, but no severe reactions occurred. Additionally, the SLIT group also had a lower frequency of wheezing episodes (0.3%) compared to the control group (0.7%), suggesting SLIT may help prevent asthma symptoms.
This study highlights SLIT’s potential to safely, and effectively, manage allergic rhinitis in young children while potentially reducing the risk of developing asthma.
Katie Wright, EMJ
Reference
Sasamoto K et al. Efficacy and safety of sublingual immunotherapy using house dust mite tablet for 1-4 years old children with perennial allergic rhinitis. Pediatr Allergy Immunol. 2024;35(7):e14203.
