Pulmonology Pulmonology
Pulmonol 2018;24:182-93 - Vol. 24 Num.3 DOI: 10.1016/j.rppnen.2017.07.009
Review
Accelerated subcutaneous immunotherapy in pediatric population – Systematic review
R.A. Gomes dos Reis Pimentela,, , G. Oliveirab, C.S. Ferreira Chaves Loureiro e Lemosc
a Hospital and University Center of Coimbra (CHUC), Coimbra, Portugal
b Faculty of Medicine of the University of Coimbra (FMUC) Pediatric Hospital of the Hospital and University Center of Coimbra (CHUC), Coimbra, Portugal
c Pediatric Hospital of the Hospital and University Center of Coimbra (CHUC), Coimbra, Portugal
Received 15 May 2017, Accepted 04 July 2017
Abstract
Background

Accelerated subcutaneous immunotherapy (SCIT) schedules represent an alternative to conventional SCIT, providing immunotherapy benefits in a shorter period of time. The objectives of this systematic review were to assess clinical and immunological efficacy as well as safety of accelerated SCIT build-up schedules for the treatment of respiratory allergy in pediatric patients.

Methods

Studies were located by searching PubMed, using “immunotherapy” and “desensitization” as keywords. The selection of studies, published from January 1st, 2006, to December 31th, 2015, was performed in two stages: screening of titles and abstracts, and assessment of the full papers identified as relevant, considering the inclusion criteria. Data were extracted in a standardized way and synthesized qualitatively to assess efficacy and safety of accelerated schedules in respiratory allergy.

Results

Eleven trials were included: two evaluated rush SCIT and nine assessed cluster SCIT. This review demonstrated that rush and cluster schedules are clinically and immunological efficacious, with faster effect than conventional schedules. No relevant difference with respect to clinical outcomes was noticed between subgroups (pediatric, adult and mixed populations). Regarding safety, most local adverse reactions were mild and there were neither life-threatening systemic reactions nor fatal events. No relevant differences in the incidence and severity of either local or systemic reactions between the accelerated schedule group and control group were registered.

Conclusions

Accelerated SCIT build-up schedules are effective in the treatment of respiratory allergy in pediatric patients, representing a safe alternative to the conventional schedules with the advantage of achieving clinical effectiveness sooner.

Abbreviations
CT, cysLT, EAACI, ECP, eNO, FEV1, ITT, MS, PEF, QLQ, QOL, RCT, SCIT, SIT, SMS, SS
Pulmonol 2018;24:182-93 - Vol. 24 Num.3 DOI: 10.1016/j.rppnen.2017.07.009