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Low‐dose local nasal immunotherapy in children with perennial allergic rhinitis due to Dermatophagoides

2002; Wiley; Volume: 57; Issue: 1 Linguagem: Inglês

10.1046/j.0105-4538.2001.00001.x-i3

1398-9995

Fabrizio Marcucci, L. Sensi, Carlo Caffarelli, Giovanni Cavagni, R. Bernardini, A. Tiri, G Riva, Elio Novembre,

Dermatology and Skin Diseases

Background: Allergen specific immunotherapy was known to be useful in the treatment of respiratory allergic disease. Local nasal immunotherapy (LNIT) offers advantages such as a good efficacy/safety ratio and a more convenient allergen delivery. The aim of this study was to assess the safety and clinical efficacy of a modified scheduling of LNIT in 32 children with allergic rhinitis due to Dermatophagoides . Methods: A multicentre, randomized, double‐blind placebo controlled study carried out for two years, with a modified schedule of LNIT treatment: a build‐up phase at increasing dosages from 2.5 AU to 80 AU and a maintenance period at low dosage (80 AU) once a week. Symptom and medication scores, threshold dose with specific nasal provocation test (NPT) and immunological parameters (IgE and IgG 4 ) were evaluated. Results: No important local or systemic side‐effects were observed in children who completed the study. Compared to placebo, the active treatment group showed significant improvement in rhinitis symptoms and a reduction of drug consumption after 18 months of LNIT. These results were confirmed by a significant reduction of allergen specific nasal reactivity. Serum and nasal specific IgE and IgG 4 did not show any difference in the two groups. Conclusions: The safety and clinical efficacy of low‐dose LNIT suggests that this therapy may be useful in the treatment of allergic rhinitis disease in children.