Abstract
Evidence regarding asthma’s impact on children’s daily lives is limited. This prospective and cross-sectional, observational, multicenter study assessed school/work and activity impairment in children and adolescents with allergic asthma and their caregivers and allergen immunotherapy (AIT) effects. Included patients were schooled children and adolescents (5 to 17 years) with allergic asthma due to house dust mites (HDM). Impairment of school/work (i.e., absenteeism and presenteeism) and activity was measured in patients and their caregivers using the Work Productivity Impairment Questionnaire plus Classroom Impairment Questions: Allergy Specific (WPAI + CIQ:AS). HDM allergic patients with school impairment received subcutaneous AIT with a MicroCrystalline Tyrosine-associated allergoid. WPAI + CIQ:AS and effectiveness variables were compared between baseline and 1-year post-AIT. Of the 113 patients included, 59 (52.2%) and 51 (45.1%) showed school and activity impairment, respectively, missing a mean (SD) of 37.6 (24.4) % and 42.6 (25.6) % of school and activity time, respectively. Twenty-six (23%) caregivers reported activity impairment and, of the 79 (69.9%) employed, 30 (38%) reported work impairment. Of the 65 patients with school/activities impairment, 41 (63.1%) received AIT, of which 21 (51.2%) completed 1 year of treatment. Effectiveness variables and WPAI + CIQ:AS significantly improved: Mean (SD) school impairment decreased from 39.7 (26.7) to 2.1 (7.1) % (p < 0.001) and activity impairment from 46.2 (34.6) to 1.4 (3.6) % (p < 0.001).Conclusion: Allergic asthma due to HDMs results in school/work and activity impairment in children and adolescents and their caregivers. One year of AIT provided clinical benefits and reduced school and activity impairment.What is Known:• Allergic asthma impairs children’s school performance and daily activities.• Allergen immunotherapy modifies allergic disease course and ameliorates its symptoms.What is New:• Asthma symptoms due to allergy to house dust mites impair children’s school attendance and productivity and daily activity and their caregivers’ work performance and daily lives.• Allergen immunotherapy with a house dust mite MicroCrystalline Tyrosine (MCT)-associated allergoid seems to provide clinical benefits, associated with decreased school and activity impairment, supporting it as an effective treatment option.
Highlights
Allergic diseases, including asthma, rhinitis, and atopic dermatitis, impair multiple aspects of patients’ daily functioning, causing a serious burden and impaired quality of life [1]
Among the most frequent allergens associated with allergic asthma, those from house dust mites (HDMs) are common in indoor environments and rank second after pollens, constituting the main cause of perennial allergic asthma in Spain [3, 4]
Among the activities impaired by asthma, school attendance is frequently hampered due to asthma exacerbations, lack of asthma control, and routine medical visits, resulting in school absenteeism [6, 7]
Summary
Allergic diseases, including asthma, rhinitis, and atopic dermatitis, impair multiple aspects of patients’ daily functioning, causing a serious burden and impaired quality of life [1]. Among the factors influencing school performance, previous studies have shown that good asthma control decreases school absenteeism and productivity, underscoring a role for regular asthma medication and inhaled corticosteroids [6, 10,11,12]. In this context, AIT, the only treatment able to modify the course of the disease and ameliorate its symptoms, may decrease children’s school and activity impairments and, those of their caregivers [13]. Among the different commercially available HDM-specific immunotherapies, Acarovac Plus® has shown a favorable effectiveness profile in previous observational studies [14,15,16,17]
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