Asia Pac Allergy.  2016 Jan;6(1):35-42. 10.5415/apallergy.2016.6.1.35.

Ultrarush schedule of subcutaneous immunotherapy with modified allergen extracts is safe in paediatric age

• Morais-Almeida M
• Arêde C
• Sampaio G
• Borrego LM

• KMID: 2396968
• DOI: http://doi.org/10.5415/apallergy.2016.6.1.35

Abstract

BACKGROUND
Traditional subcutaneous immunotherapy up dosing with allergenic extracts has been shown to be associated with frequent adverse reactions. In recent studies it has been demonstrated that using modified extracts, namely allergoids, it is a safe and effective procedure particularly on accelerated schedules. However data assessing its safety in paediatric age is scarce.
OBJECTIVE
To evaluate the safety profile in paediatric population of using modified allergen extracts, in an ultrarush schedule, to reach the maintenance dose in the first day.
METHODS
We included children undergoing treatment with subcutaneous immunotherapy during a five-year period, using modified aeroallergen extracts, depigmented, polymerized with glutaraldehyde and adsorbed on aluminium hydroxide using an ultrarush induction phase. The type of adverse reactions during the ultrarush protocol was recorded.
RESULTS
We studied 100 paediatric patients (57 males) with a mean age of 11.6 years (5 to 18 years; standard deviation, 3.3), all with moderate to severe persistent rhinitis, with or without allergic conjunctivitis, asthma and atopic eczema, sensitized to mites and/or pollens. All reached the maintenance dose of 0.5 mL in the first day, except 1 child. During the ultrarush protocol the total number of injections was 199. There were 21 local adverse reactions in 11 patients, 11 immediate and 10 delayed; from those, had clinical relevance 1 immediate and 4 delayed. Systemic reactions were recorded in 2 cases, both immediate and mild.
CONCLUSION
The ultrarush protocol, without premedication, was a safe alternative to be used in paediatric age during the induction phase of subcutaneous immunotherapy using allergoid depigmented extracts.

Keyword

Adverse Events; Allergens; Allergoids; Immunotherapy; Pediatrics; Safety

MeSH Terms

Allergens
Appointments and Schedules*
Asthma
Child
Conjunctivitis, Allergic
Dermatitis, Atopic
Glutaral
Humans
Immunotherapy*
Mites
Pediatrics
Pollen
Polymers
Premedication
Rhinitis
Allergens
Glutaral
Polymers

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