Valdesoiro-Navarrete Laura, León María Esther, Rodríguez Marcos, Indiveri Martina, Ayats Roser, Larramona Helena, González Miguel García, de la Cruz Òscar Asensio, García Montserrat Bosque
Paediatric Allergies, Immunology and Pneumology Unit, Paediatric Medicine Service, Parc Taulí University Hospital of Sabadell, Barcelona, Spain.
Institut d'Investigació i Innovació Parc Taulí, Sabadell, Spain;
Allergol Immunopathol (Madr). 2022 Mar 1;50(2):1-6. doi: 10.15586/aei.v50i2.469. eCollection 2022.
In most cases, severe asthma in children has an allergic etiology, but allergen-specific immunotherapy (AIT) is contraindicated.
This study aimed at analyzing the safety and efficacy of AIT in patients with severe asthma treated with omalizumab (OM).
A descriptive real-life study was carried out by reviewing medical records. Effectiveness was measured by the degree of control (CAN questionnaire), number of hospitalizations per year, number of exacerbations per year, and maintenance treatment and lung function (FEV1). Some adverse reactions occurred (AAI-EAACI-WAO guidelines).
The retrospective study included 29 patients up to 18 years of age with severe asthma with OM plus AIT treatment. AIT treatment was started in a cluster schedule when patients treated with OM achieved disease control. Before starting AIT, patients were treated with OM for 1 year for achieving asthmatic control. AIT to mites (51%), (37.9%), or pollens (10.3%) was administered. After one year with OM plus AIT,statistically significant differences in CAN scores and FEV1 measures were observed (P < 0.001). No patients under treatment with OM plus AIT required hospital admission. During the clustering schedule, only 3/64 doses showed systemic adverse reactions. During the AIT maintenance treatment, 348 doses were administered, with no significant adverse reactions.
In this population-based study in children with severe asthma, the combined treatment with OM plus AIT was safe and effective. This strategy allows these pediatric patients to be safely treated with AIT.
在大多数情况下，儿童重度哮喘具有过敏性病因，但变应原特异性免疫疗法（AIT）是禁忌的。
本研究旨在分析AIT在接受奥马珠单抗（OM）治疗的重度哮喘患者中的安全性和有效性。
通过查阅病历进行描述性的真实生活研究。有效性通过控制程度（哮喘控制问卷）、每年住院次数、每年发作次数、维持治疗和肺功能（第一秒用力呼气容积）来衡量。记录一些不良反应的发生情况（按照AAI-EAACI-WAO指南）。
这项回顾性研究纳入了29例18岁以下接受OM加AIT治疗的重度哮喘患者。当接受OM治疗的患者病情得到控制时，以集群方案开始AIT治疗。在开始AIT之前，患者接受OM治疗1年以实现哮喘控制。给予针对螨虫（51%）、（此处原文缺失）（37.9%）或花粉（10.3%）的AIT治疗。在使用OM加AIT治疗一年后，观察到哮喘控制问卷评分和第一秒用力呼气容积测量值有统计学显著差异（P < 0.001）。没有接受OM加AIT治疗的患者需要住院。在集群方案期间，仅3/64剂出现全身不良反应。在AIT维持治疗期间，共给予348剂，未出现显著不良反应。
在这项针对重度哮喘儿童的基于人群的研究中，OM加AIT联合治疗是安全有效的。这种策略使这些儿科患者能够安全地接受AIT治疗。
