Safety and tolerability of ultra-rush induction, less than one hour, of sublingual immunotherapy in children

Int Arch Allergy Immunol. 2006;139(2):149-52. doi: 10.1159/000090391. Epub 2005 Dec 22.

Abstract

Background: The safety and tolerability of sublingual immunotherapy (SLIT) has been documented in allergic patients both in the build-up phase as well as during maintenance, but only two studies have evaluated the occurrence of adverse reactions with an ultra-rush regimen of SLIT induction in a mixed paediatric/adult population. Moreover one of these two studies used a chemically modified extract (allergoid). The aim of the present study was to evaluate the occurrence of immediate or late adverse reactions in allergic children after a very fast (40 min) ultra-rush SLIT induction with two different allergen extract solutions.

Methods: We studied 100 children (64 boys, mean age of 9.6 years, range 3.5-16.8), with a history of intermittent/persistent rhinitis and/or intermittent/mild persistent asthma due to inhalant allergens. The ultra-rush build-up phase involved the administration, every 10 min, of increasing doses of the highest-concentration vial of SLIT of two different manufacturers (Anallergo and Stallergènes).

Results: All patients completed the treatment, side-effects have been recorded in 19% of the cases: 10% within 1 h after the build-up phase, 7% within 48 h and 2% mixed. A major difference (p = 0.0001) was recorded between Anallergo (6 patients, 8.7%) and Staloral (13 patients, 41.9%), but all the reactions were mild: principally oral symptoms, in 1 case rhinorrhoea and cough, and delayed abdominal pain and diarrhoea in another patient.

Conclusions: No severe adverse reactions were observed with this ultra-rush SLIT induction also in the paediatric age; statistical differences have been documented between the two different extracts.

MeSH terms

  • Administration, Sublingual
  • Adolescent
  • Allergens / administration & dosage
  • Allergens / adverse effects
  • Asthma / therapy
  • Child
  • Child, Preschool
  • Conjunctivitis, Allergic / therapy
  • Dermatitis, Atopic / therapy
  • Desensitization, Immunologic / adverse effects*
  • Desensitization, Immunologic / methods*
  • Female
  • Humans
  • Hypersensitivity, Immediate / drug therapy*
  • Male
  • Rhinitis, Allergic, Perennial / therapy

Substances

  • Allergens