Promising results with SLIT for childhood grass pollen allergy

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By Helen Albert, Senior medwireNews Reporter

High-dose sublingual immunotherapy (SLIT) effectively reduces allergic symptoms and medication use in children with grass pollen-allergic rhinoconjunctivitis, show study results.

SLIT, given as drops or tablets placed under the tongue, has shown promise for treating allergy in adults in previous studies, as an alternative to subcutaneous immunotherapy, explain the authors.

To test its viability in children, Ulrich Wahn (Charité Medical University, Berlin, Germany) and colleagues carried out a randomized, placebo-controlled trial of high-dose SLIT for grass pollen allergy in 179 children (132 SLIT; 47 placebo) aged 4‑12 years.

The children who received SLIT were given up to 4 drops per day (3600‑4800 µg) of a aqueous grass solution containing equal extracts from six species of grass (Dactylis glomerata, Festuca pratensis, Holcus lanatus, Lolium perenne, Phleum pratense, and Poa pratensis). Treatment took place between January and August.

Change in the area under the curve for the symptom-medication score (SMS) was used to assess treatment efficacy. The mean change in the area under the curve was significantly greater for the SLIT group compared with the placebo group, at -212.5 versus -97.8. Levels of allergen-specific immunoglobulin (Ig)E and IgG also changed indicating a "significant immunologic effect," notes the team.

The SMS for rhinoconjunctivitis and separated symptom and medication scores was also significantly improved in the SLIT versus the placebo group.

There were also more "well days" and more responders to treatment in the SLIT versus the placebo group.

"This study confirmed that this SLIT preparation significantly reduced symptoms and medication use in children with grass pollen-allergic rhinoconjunctivitis," write Wahn et al in the Journal of Allergy and Clinical Immunology.

"Such standardized studies in the pediatric population are considered necessary and will allow researchers to compare different results and to build more appropriate meta-analyses with more reliable conclusions about SLIT efficacy and safety in allergic children."

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