• Elio Novembre, Elena Galli, Fabiola Landi, Carlo Caffarelli, Massimo Pifferi, Emanuela De Marco, Samuele E Burastero, Giliola Calori, Luca Benetti, Paolo Bonazza, Paola Puccinelli, Silvano Parmiani, Roberto Bernardini, and Alberto Vierucci.
• Research Centre, Hospital "San Pietro Fatebenefratelli," AFaR, Rome.
• J. Allergy Clin. Immunol. 2004 Oct 1;114(4):851-7.

BackgroundWe wondered whether short-term coseasonal sublingual immunotherapy (SLIT) can reduce the development of asthma in children with hay fever in an open randomized study.ObjectiveWe sought to determine whether SLIT is as effective as subcutaneous immunotherapy in reducing hay fever symptoms and the development of asthma in children with hay fever.MethodsOne hundred thirteen children aged 5 to 14 years (mean age, 7.7 years) with hay fever limited to grass pollen and no other clinically important allergies were randomized in an open study involving 6 Italian pediatric allergy centers to receive specific SLIT for 3 years or standard symptomatic therapy. All of the subjects had hay fever symptoms, but at the time of study entry, none reported seasonal asthma with more than 3 episodes per season. Symptomatic treatment was limited to cetirizine, loratadine, nasal budesonide, and salbutamol on demand. The hay fever and asthma symptoms were quantified clinically.ResultsThe actively treated children used less medication in the second and third years of therapy, and their symptom scores tended to be lower. From the second year of immunotherapy, subjective evaluation of overall allergy symptoms was favorable in the actively treated children. Development of asthma after 3 years was 3.8 times more frequent (95% confidence limits, 1.5-10.0) in the control subjects.ConclusionsThree years of coseasonal SLIT improves seasonal allergic rhinitis symptoms and reduces the development of seasonal asthma in children with hay fever.

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