Allergen Immunotherapy for Allergic Rhinitis is more Effective in Children vs Adults

Background: The natural course of allergic rhinitis (AR) and Allergic asthma (AA) is an average increase in symptoms during the first and second decades of life with symptomatic remission in later adulthood. Allergen immunotherapy (AIT) is the only curative treatment available for allergic rhinitis (AR) and allergic asthma (AA). Sublingual AIT has recently been included in the Global Initiative for asthma (GINA) guidelines to treat step2-4 patients aged 12 and older. However AIT is prescribed mostly to adult patients, and most published data on effectiveness relates do treatment of adults.

Aims: The primary aim is to compare between children and adults in symptom score reduction following and during AIT.

Methods: A retrospective medical record review. Patients who completed the Total Nasal Symptom Score (TNSS) questionnaire prior to and during AIT were included in the analysis. The delta change in symptom score was compared between adult and pediatric patients. Pediatric patients were younger than 18 upon starting AIT.

Results: 152 adults and 22 children completed the TNSS questionnaire before beginning and after reaching maintenance dose of AIT. The delta change in symptom score was 8.13 in pediatric patients and 5.6 in adult patients.

Discussion: TNSS scores prior to treatment were higher in children vs adults (16.8 vs. 13.7) so a selection bias is possible.

Conclusions: AIT is more effective in children and should be initiated earlier.