The Rate of Systemic Reactions In Pediatric Patients Receiving Standardized Allergen Subcutaneous Immunotherapy Is Elevated and Not Affected by Seasonal Dose Adjustment
Sunday, March 4, 2018: 2:45 PM
S310AB (Convention Center)
Sultan Albuhairi, MD, , , , , , , ,
RATIONALE: The 2003 Joint-Task-Force-on-Practice-Parameters recommended standardizing allergen subcutaneous immunotherapy (SCIT). Longitudinal surveillance surveys in North America reported systemic reactions (SR) rate of 0.1-0.2% of injection-visits. SR rate to standardized SCIT in pediatric patients has not been well evaluated

METHODS: We evaluated the rate of SRs to standardized SCIT in patient’s age 5-18 years in a US tertiary care center with and without seasonal dose adjustment. A retrospective chart review was conducted in 2 groups: Group1 started SCIT within a period from January 2009-June 2012, while group 2 started SCIT within the period from January 2013-June 2016. The protocol was modified in group 2 such that updosing and maintenance doses were adjusted in the spring for tree and grass pollen and in the fall for weed pollen.

RESULTS: There were a total of 124 patients in group 1 and 118 patients in group 2. The rate of SR was 0.429% in group 1 and 0.364% in group 2, which was not significant. There was no difference in the severity of SR in the 2 groups with no fatal or near-fatal SR noted. Asthma was a significant risk factor in the younger patients age 5-11 year.

CONCLUSIONS: To date, this is the largest US pediatric SCIT study on SR rate. Standardized SCIT appears to be associated with a higher rate of SRs in pediatric patients compared to the literature. Seasonal dose modification did not significantly affect SR. Larger multi-centered studies are required to evaluate the safety and efficacy of SCIT dosing in the pediatric population.