Eassi Survey: European Multicentre Prospective Study to Collect Systemic Adverse Reactions Due to Allergen Immunotherapy: Pediatric Population Results

Rationale:

Systemic adverse reactions (SAR) due to Allergen Immunotherapy (AIT) still represent one of its major drawbacks preventing a more extensive use of this etiologic treatment. The objective of this EAACI-supported survey was to collect SAR due to aeroallergen AIT in real life practice

Methods:

Data was centrally collected with an online database, and gathered through three different questionnaires: DQ: doctor questionnaire (filled in only once by each participant doctor), PQ: patient questionnaire (one per patient-treatment) and RQ: reaction questionnaire (one per reaction). Harmonized MedDRA terminology for SAR due to AIT was used

Results:

Three countries (France, Germany and Spain), 95 doctors and 1578 pediatric patient-treatment were recruited, mean age 11.7 years(+/-SD 3.9), 59.1%(932) males. Allergic asthma and rhinitis/rhinoconjunctivitis was the AIT indication in 56.1%(886) patients, allergic rhinitis/rhinoconjunctivitis without asthma in 38.3%(604), asthma alone in 5.2%(82) and conjunctivitis alone in 0.4%(6) patients. Monoallergen AIT composition was 49%mites, 25.8%grass, 8.7%tree, 4.6%Alternaria, 0.8%epithelia, 0.6%weeds and 10.5% were mixtures. Subcutaneous AIT (SCIT) was used in 71.4% (n=1127). A total estimation of 19.669 and 131.550 doses of SCIT and sublingual AIT (SLIT) were given, and 29 SAR (79.3%SCIT) were recorded in 24 patient-treatments, 3 were anaphylaxis and only 1 was severe. SAR were more frequent in up-dosing (79.3%) but milder (82.6%mild) than in maintenance (33.3%mild) (p= 0.023). The use of natural extracts compared to allergoids was associated with higher risk of suffering SAR (OR=8.4, 95%CI: 1.9-36.5)

Conclusions:

AIT showed to be a safe treatment with a low rate of SAR and even lower ratio of severe SAR