Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence

Table 1 Randomized double-blinded placebo controlled trials on grass pollen sublingual Immunotherapy for the treatment of allergic rhinits in children

Ref.	Year	Age	No. of patients	Product	Efficacy parameters	Duration	Statisticalsignificance	Other observation
Wüthrich et al[13]	2003	4-11	22	ALK-Abello’	Medication score	2 yr	P = 0.05	A difference in drug consumption has been shown only in the second year
Bufe et al[14]	2004	6-12	161	Sublivac BEST, HAL-allergy	Clinical Index (combining	3 yr	P = 0.046	A significant difference was shown in patients with severe symptoms
					symptom and medication score)
Rolinck-Werninghaus[15]	2004	3-14	97	Pangramin-SLIT	Multiple symptom – medication score	32 mo	P = 0.498	Symptom score did not reveal significant difference; medication score improve significantly (P = 0.0025)
				ALK-SCHERAX
Novembre et al[16]	2004	5-14	113	ALK-Abello’	Medication score	3 yr	P < 0.05	Significant improvement was shown after the second year; symptom score did not improve significantly
Röder et al[17]	2007	6-18	204	Oralgen Grass Pollen, Artu Biologicals	Medication and symptom score	2 yr	NS	Study population was enrolled from general practices
Wahn et al[18]	2009	5-17	278	5-grass tablets 300IR,	Rhinoconjunctivitis total symptom score	6 mo	P = 0.001	SLIT was started 4 mo before before the pollen season; both symptom score and medication score improved singularly too
Bufe et al[19]	2009	5-16	253	Stallergenes	Medication and symptom score	4-6 mo	P < 0.02	SLIT was started 8 to 23 wk before the estimated pollen season in 2007
				SQ-standardized grass allergen tablet (Grazax)
Halken et al[20]	2010	5-17	267	5-grass tablets 300IR,	Medication and symptom score	6 mo	P < 0.01	SLIT was started 4 mo before the estimated pollen season
Stelmach et al[29]	2011	6-18	60	Stallergenes Staloral 300IR, Stallergenes	Combined symptom and medication score	2 yr	P < 0.01	Both pre-coseasonal and continuous regimen were efficacious in the same extent
Blaiss et al[21]	2011	5-17	345	SQ-standardized grass allergen tablet (Grazax)	Medication and symptom score	6 mo	P < 0.01	SLIT started 8 wk before the pollen 2009 season; 89% patients were multi-sensitized
Wahn et al[23]	2012	4-12	207	6-grass pollen aqueous extract (AllerSlit, Allergopharma)	Area under the curve of symptom-medication score	6-8 mo	P = 0.004	Patients were treated with a pre-coseasonal regimen; after this first phase, unblinding was made and all patients were treated
Ahmadiafshar et al[22]	2012	5-18	24	Staloral 300IR, Stallergenes	Medication and symptom score	6 mo	P < 0.05	SLIT was started 8-10 wk before pollen season

SLIT: Sublingual Immunotherapy; NS: Not significant.

Table 2 Randomized double-blinded placebo controlled trials on house dust mite sublingual Immunotherapy for the treatment of allergic rhinitis in children

Ref.	Year	Mean age (yr)	No. of patients	Product	Efficacy parameters	Duration	Statisticalsignificance	Other observation
Marcucci et al[33,34]	2005	4-15	24	Aqueous solution (ALK-Abello’)	Symptoms score	1 yr	NS	A significant difference was recorded in the last trimester of the year; the study was carried on after the first year in open way
Tseng et al[31]	2008	6-18	59	Staloral (Stallergenes)	Symptoms score	6 mo	NS	In treated group a slight improvement was recorded. Specific IgG4 and IgG4/IgE significantly increased in SLIT group
Yonekura et al[35]	2010	7-15	31	Extract of house dust mite (Torii Pharmaceutical)	Symptom score	40 wk	P < 0.05	The improvement in SLIT group increased progressively according to the duration of the therapy
de Bot et al[36]	2012	6-18	251	Oralgen House Dust Mite (Oralgen Mijten)	Symptom score	2 yr	NS	Study population was recruited in primary care setting
Aydogan etal[41]	2013	5-10	22	Staloral (Stallergenes)	Medication and symptom score	12 mo	NS	-

SLIT: Sublingual Immunotherapy; NS: Not significant.