Unidad de Neumología y Alergia Pediátrica, Instituto de Investigaciones Sanitarias, Hospital Universitario La Fe, Valencia, Spain.
Departmento de Pediatría, Manises Hospital, Valencia, Spain.
Am J Respir Crit Care Med. 2021 Aug 15;204(4):462-472. doi: 10.1164/rccm.202003-0520OC.
Recurrent wheezing in children represents a severe public health concern. Wheezing attacks (WA), mainly associated with viral infections, lack effective preventive therapies. To evaluate the efficacy and safety of mucosal sublingual immunotherapy based on whole inactivated bacteria (MV130) in preventing WA in children. A Phase 3 randomized, double-blind, placebo-controlled, parallel-group trial including a cohort of 120 children <3 years old with ⩾3 WA during the previous year was conducted. Children with a positive skin test to common aeroallergens in the area where the clinical trial was performed were excluded from the trial. Subjects received MV130 or placebo daily for 6 months. The primary endpoint was the number of WA within 1 year after the first dose comparing MV130 and placebo. There was a significant lower number of WA in MV130 versus the placebo group, 3.0 (interquartile range [IQR], 2.0-4.0) versus 5.0 (IQR, 3.0-7.0) ( < 0.001). As secondary outcomes, a decrease in the duration of WA and a reduction in symptoms and medication scores in the MV130 versus placebo group were found. No adverse events were reported related to the active treatment. Mucosal bacterial immunotherapy with MV130 shows safety and clinical efficacy against recurrent WA in children.Clinical trial registered with www.clinicaltrials.gov (NCT01734811).
儿童反复喘息是一个严重的公共卫生问题。喘息发作(WA)主要与病毒感染有关,缺乏有效的预防疗法。为评估基于全灭活细菌(MV130)的黏膜舌下免疫疗法预防儿童 WA 的疗效和安全性。一项 3 期随机、双盲、安慰剂对照、平行组试验纳入了 120 名 <3 岁、过去 1 年有 ⩾3 次 WA 的儿童。在进行临床试验的地区对常见气传过敏原进行皮肤点刺试验阳性的儿童被排除在试验之外。受试者每日接受 MV130 或安慰剂治疗 6 个月。主要终点是比较 MV130 和安慰剂组首次给药后 1 年内 WA 的数量。MV130 组 WA 的数量明显少于安慰剂组,分别为 3.0(四分位间距 [IQR],2.0-4.0)和 5.0(IQR,3.0-7.0)( < 0.001)。作为次要结局,与安慰剂组相比,MV130 组 WA 的持续时间缩短,症状和药物评分降低。未报告与活性治疗相关的不良事件。MV130 黏膜细菌免疫治疗对儿童反复 WA 具有安全性和临床疗效。临床试验在 www.clinicaltrials.gov 上注册(NCT01734811)。