Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma

Abstract

Background Evidence begin to accumulate that high-dose sub-
lingual immunotherapy (SLIT) is as effective as subcutaneous
immunotherapy (SIT) in the treatment of childhood asthma.
Since the capacity of sublingual area is similar whether the dose
is high or low, the efficacy of low dose may be important to be
studied.
Objective To investigate the efficacy of low-dose sublingual im-
munotherapy in the treatment of childhood asthma.
Methods Parents signed informed consent prior to enrollment,
after having received information about the study. Patients were
moderate asthma aged 6-14 years with disease onset of less
than 2 years before the commencement of the study and peak
expiratory flow rate (PEFR) variability of more than 15%. Pa-
tients were randomly allocated into group A, B, and C who
received subcutaneous immunotherapy, low-dose sublingual
immunotherapy, and conventional asthma therapy, respectively.
Randomization was stratified into two strata according to age
i.e., 6-11 years or 11-14 years. Patients of each stratum were
randomized in block of three for each group. At the end of three
months, lung function tests were repeated. The primary outcome
was PEFR variability at the end of the study. The study was
approved by the Ethics Committee of Soetomo Hospital
Surabaya.
Results Distribution of variants as represented by sex, age,
eosinophil count, and total IgE concentration were normal in
the three groups. PEFR variability decreased significantly from
16.97+0.81 to 8.50+5.08 and 17.0+0.87 to 8.40+4.72 in group
receiving SIT and SLIT, respectively (p<0.05), but decreased
not significantly from 17.00+0.83 to 10.82+0.5.41 in control group
(p>0.05).
Conclusion Low-dose SLIT is as efficacious as SIT in the treat-
ment of moderate asthma in children