Efficacy and safety of allergen-specific immunotherapy in children

Abstract

Atopic diseases are one of the most common chronic diseases in children and adolescents. They lead to a significant deterioration in the quality of life of patients and their families. The only strategy for the treatment of atopic diseases that has a disease-modifying effect is allergen-specific immunotherapy. The purpose of this review is to summarize the literature data on the practical aspects of allergen-specific immunotherapy use in children and adolescents with allergic rhinoconjunctivitis and atopic bronchial asthma. An analysis of scientific articles has shown that allergen-specific immunotherapy can reduce the severity of symptoms of allergic rhinoconjunctivitis and/or atopic bronchial asthma and reduce the amount of pharmacotherapy, as well as reduce the risk of bronchial asthma developing in patients with allergic rhinoconjunctivitis. The current evidence of the preventive effect of allergen-specific immunotherapy in relation to the development of new sensitizations in monosensitized patients is unconvincing, and, according to many authors, new randomized clinical trials are needed. According to most experts, allergen-specific immunotherapy should be started in children from 5 years of age in the presence of proven immunoglobulin E-mediated sensitization to one or more allergens, carried out for at least 3 years, using preparations in which the presence of major allergens is documented. At the same time, both subcutaneous and sublingual administration of allergens has comparable effectiveness. Allergen-specific immunotherapy is a safe and well-tolerated treatment for children, but currently there is no generally accepted classification of possible adverse events, as well as a standardized and uniform system for assessing their severity.