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3至13岁变应性鼻炎儿童舌下免疫治疗的疗效与安全性

Efficacy and safety of sublingual immunotherapy in children aged 3-13 years with allergic rhinitis.

作者信息

Shao Jie, Cui Yu-xia, Zheng Yu-fei, Peng Han-fen, Zheng Zhu-li, Chen Jing-ya, Li Qin, Cao Lan-fang

机构信息

Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Am J Rhinol Allergy. 2014 Mar-Apr;28(2):131-9. doi: 10.2500/ajra.2014.28.4006.

Abstract

BACKGROUND

Sublingual immunotherapy (SLIT) is recommended for allergic diseases. However, clinical studies containing evidence-based data of this treatment in young children, which is rarely reported in the literature, are needed. This study was designed to assess the efficacy and safety of SLIT in children, including very young children.

METHODS

Two hundred sixty-four children aged 3-13 years old (133 children, 3-5 years old) with Dermatophagoides farinae-induced allergic rhinitis with or without asthma treated by standard pharmacotherapy had randomly received either SLIT (SLIT group) or no SLIT (control group) for 12 months. Symptoms, medications, visual analog scale (VAS) and presence of adverse events (AEs) were assessed at monthly visits. Skin-prick test and Dermatophagoides farinae-specific IgE and IgG4 were measured before and after treatment.

RESULTS

Both treatments were effective in the global clinical scores during the first seven visits when compared with baseline (all, p < 0.01), and SLIT showed lower symptoms scores and VAS scores throughout this period (all, p < 0.01). These improvements continued until the later visits only in the SLIT group. Also, the asthma medication consumption was decreased by SLIT treatment only at the end of study (p < 0.01). The specific IgG4 was significantly increased after SLIT treatment when compared with the control group, but no significant change of specific IgE was observed in either groups. In the SLIT group, there was no significant difference between children less than or more than 5 years old in terms of clinical efficacy, onset of action, immunologic parameters, and safety. No severe systemic AEs were reported.

CONCLUSION

SLIT is effective and well-tolerated in children with allergic rhinitis 3-13 years old.

摘要

背景

舌下免疫疗法(SLIT)被推荐用于治疗过敏性疾病。然而,关于该疗法在幼儿中的循证医学数据的临床研究在文献中鲜有报道,因此需要开展此类研究。本研究旨在评估SLIT在儿童(包括低龄儿童)中的疗效和安全性。

方法

264名3至13岁(其中133名3至5岁)因粉尘螨诱发过敏性鼻炎伴或不伴哮喘且接受标准药物治疗的儿童被随机分为两组,一组接受SLIT治疗(SLIT组),另一组不接受SLIT治疗(对照组),疗程为12个月。每月随访时评估症状、用药情况、视觉模拟量表(VAS)评分以及不良事件(AE)的发生情况。治疗前后分别检测皮肤点刺试验、粉尘螨特异性IgE和IgG4。

结果

与基线相比,在前七次随访期间,两种治疗方法在总体临床评分上均有效(均为p < 0.01),且在此期间SLIT组症状评分和VAS评分更低(均为p < 0.01)。这些改善仅在SLIT组持续至后续随访。此外,仅在研究结束时,SLIT治疗使哮喘药物消耗量减少(p < 0.01)。与对照组相比,SLIT治疗后特异性IgG4显著升高,但两组特异性IgE均无显著变化。在SLIT组中,5岁及以下和5岁以上儿童在临床疗效、起效时间、免疫参数和安全性方面无显著差异。未报告严重全身性AE。

结论

SLIT对3至13岁过敏性鼻炎儿童有效且耐受性良好。

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