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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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SUBCUTANEOUS ALLERGEN IMMUNOTHERAPY EVALUATION IN A PEDIATRIC POPULATION

Cátia Alves, Susana Palma Carlos, Paula Leiria Pinto

Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE

- XXXVI European Academy of Allergology Clinical Immunology, Helsínquia, 17-21 Junho 2017
- Apresentação como comunicação oral; publicação de resumo
- Reunião Internacional

Resumo:
Introduction: Respiratory allergic disease (RAD) is a growing concern in our population. Allergen immunotherapy (AIT) is, currently, the only approach to IgE-mediated allergic disorders that can induce specific immune tolerance, and is well stablish, mostly in adults. New polymerized extracts, more immunogenic and less allergenic, are emerging. The safety and efficacy assessment of this new extracts in children is important.
Objective: Evaluate safety and efficacy of the subcutaneous immunotherapy (SCIT) with polymerized extracts in children.
Material and methods: Children with RAD, to whom SCIT was proposed, were included and followed during 24 to 60 months (µ±SD 39,28 ±8,23). Amount of pharmacotherapy needed to achieve RAD control, skin prick test (SPT), specific IgE (sIgE) and adverse reactions were analysed in 2 moments, initial (IE) and final (FE) evaluation, and compared between two groups, with SCIT (y-SCIT) and without SCIT (n-SCIT). For the statistical analysis was used SPSS V23.
Results: 36 patients with ages between 6 to 17 years were included; 25 y-SCIT, 11 n-SCIT, age groups (µ±SD) 10,84 ±3,24 and 8,55±2,67, respectively. In the IE, there is a significant (Monte Carlo p 0,002) and very high (V2 0,54) association between y-SCIT and a higher pharmacologic step to achieve asthma control. It was found a significant association (Monte Carlo p 0,001) and of high intensity (V2 0,36) between SCIT and less rhinitis pharmacotherapy needs in FE. The final sIgE was lower in y-SCIT group (t test; p 0,038). No difference was found between the two groups concerning SPT dimensions. 3 patients had a local reaction; none have had systemic reactions.
Conclusion: SCIT is safe in children. The higher pharmacotherapy step to achieve asthma control in IE of y-SCIT group may have been the reason to patients choose SCIT. AIT is associated with lower sIgE, and less preventive pharmacologic treatment needed to control RAD (consistent with previous studies). Our goal is to continue following these patients and increase the sample to improve this work accuracy.

Palavras Chave: Allergen immunotherapy in children; safety and efficacy of the subcutaneous immunotherapy