Long-Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis

Otolaryngol Head Neck Surg. 2024 Mar;170(3):919-927. doi: 10.1002/ohn.614. Epub 2023 Dec 17.

Abstract

Objective: To evaluate the efficacy and safety of dust mite subcutaneous immunotherapy (SCIT) in monosensitized and polysensitized children with allergic rhinitis (AR).

Study design: Prospective cohort study.

Setting: Tertiary referral center.

Methods: One hundred thirty children were enrolled and categorized into 2 groups: monosensitized to only dust mites and polysensitized to at least 1 additional allergen beyond dust mites. All patients received SCIT targeting dust mites for 3 years, followed by a 5-year monitoring period. The Total Nasal Symptom Score (TNSS), Symptom and Medication Score (SMS), Visual Analogue Scale (VAS), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed before SCIT (T0); at 1 (T1) and 2 (T2) years of SCIT; immediately after SCIT (T3); and 2 years post-SCIT (T5). Safety was assessed based on adverse events (AEs).

Results: Fifty-one monosensitized and 50 polysensitized children completed the study. At T3, 47 monosensitized and 46 polysensitized children were effectively treated, with no significant between-group difference in efficacy (P > .05). The TNSS, SMS, VAS scores, and RQLQ score were significantly lower at T1, T2, T3, and T5 than at T0 in both groups (P < .05). The differences in the TNSS, SMS, VAS score, and RQLQ score between the 2 groups were nonsignificant at T0, T1, T2, and T3 (P > .05), but significant at T5 (P < .05). No serious AEs were reported.

Conclusion: Monosensitized and polysensitized children exhibited similar beneficial efficacy and safety after 3 years of dust mite SCIT. Monosensitized children derived more benefits 2 years after discontinuation.

Keywords: allergic rhinitis; efficacy; monosensitized; polysensitized; subcutaneous immunotherapy.

MeSH terms

  • Allergens
  • Animals
  • Antigens, Dermatophagoides / therapeutic use
  • Child
  • Dust
  • Humans
  • Immunotherapy
  • Prospective Studies
  • Pyroglyphidae
  • Quality of Life
  • Rhinitis, Allergic* / drug therapy
  • Sublingual Immunotherapy* / adverse effects
  • Treatment Outcome

Substances

  • Antigens, Dermatophagoides
  • Allergens
  • Dust