EFFICACY AND SAFETY OF SUBLINGUAL IMMUNOTHERAPY IN ALLERGIC ASTHMA AMONG CHILDREN AND ADOLESCENTS INTERVENTIONAL STUDY

Abstract

Background: bronchial asthma is a chronic inflam­matory disorder with bronchial hyper-responsiveness. Environmental exposure in sensitized individuals is a major inducer of Allergy-associated asthma in children and adults, sublingual immunotherapy (SLIT) leads to improvement in their pulmonary functions and asthma control. Objectives: To Evaluate the Efficacy and Safety of Sublingual Immunotherapy in Allergic Asthma among Children and Adolescents. Methods: A 12 months prospective, open, low Interventional, Randomized, Controlled, single-site Study (Egyptian company for production of vaccines, sera and drugs VACSERA, allergy, and immunology clinic) was conducted between March 29, 2016, and December 27, 2018. Four groups including 62 allergic asthmatics patients both children (n = 30), and adults (n = 32), evaluating SLIT for a single-allergen (i.e. house dust mite) for 12 months, Adults received either SLIT with the pharmacotherapy (n = 17), or pharmacotherapy alone (n = 15).Children received either SLIT with the pharmacotherapy (n = 14), or pharmacotherapy alone (n = 16). Physiological parameters (Spirometry), Asthma control Questionnaires, A complete blood picture including peripheral blood Eosinophilic count, and the environmental preventive therapy were done to all patients. Results: After 1-year treatment of patients treated with SLIT and pharmacotherapy, were compared with those who received pharmacotherapy alone. There was a significant improvement in asthma control score, a significant increase in actual FEV1, FVC in SLIT with the pharmacotherapy groups in adults and children when compared with pharmacotherapy alone. There was a significant decrease in the eosinophilic count when compared with patients treated with the pharmacotherapy alone. There is a significant difference between children and adults regarding the occurrence of adverse effects in the form of Local reaction not requiring treatment (mouth, throat, and skin; irritation/swelling/pain) reported in SLIT with the pharmacotherapy groups. Conclusion: patients treated with SLIT demonstrated clinical improvement compared with those who received pharmacotherapy in adult asthmatics and children sensitized to HDM.