Allergologia et immunopathologia
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Allergen specific immunotherapy has been shown to be effective in rigorous double-blind placebo-controlled clinical trials in both children and adults A recent WHO position paper stated that immunotherapy is an effective treatment for patients with allergic rhinitis/conjunctivitis, allergic asthma and allergic reactions from stinging insects and is thought to be more effective in children than in adults. When speaking about children there are several questions that are important regarding the natural course of the disease. One of the most important is whether immunotherapy can prevent asthma, either by preventing sensitisation to allergens related to the development of asthma or by preventing the inflammation in the lungs caused by allergen exposure. ⋯ In a retrospective study of children treated with immunotherapy during childhood for at least three years, that were re-evaluated in early adulthood, the control patients who were treated with medication and no immunotherapy suffered almost 3.5 times more symptoms than the active group treated with immunotherapy. The current findings suggest that immunotherapy should be considered earlier in the course of allergic disease to prevent progression or to prevent the development of new sensitisation. Further studies with long term follow up particularly in children could address this possibility.
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Allergol Immunopathol (Madr) · May 2000
Review[Evaluation of the pediatric aspects of the WHO document and meta-analysis of immunotherapy].
In spite of the existence of numerous scientific studies on the beneficial effect of immunotherapy with specific allergens in the treatment of allergic diseases, their results have not been easily accepted as the methodology and the valuation of the studies have been very heterogeneous. Over the last few years the meta-analysis technology has been developed as a useful tool to globally value the results on the different research studies related to a specific problem. When meta-analyse are carried out correctly, they are accepted as an optimum way to express the results obtained from the different studies from a common view point. ⋯ The patients age is another factor to be considered and, except in the case of allergy to hymenoptera poison, when the patient is under 5 it is a relative counter indication to administer immunotherapy. In general it is admitted that immunotherapy is more efficient on children than on adults, but more studies need to be carried out on the efficiency and safety on children under 5. The early treatment with immunotherapy in children who suffer from allergic respiratory illnesses can have an important significance, as this type of treatment could have a preventive nature as it prevents the rhinitis developing into asthma, as well as the beneficial effect that has been shown on children with allergic asthma.
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Allergol Immunopathol (Madr) · May 2000
Multicenter Study Comparative Study[Utilization and clinical validation of the Spanish version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Diary for Caregivers of Asthmatic Children (DCA). VALAIR study].
Asthma is one of the most frequent chronic illnesses in paediatric age children. In the last reviews carried out by the group of experts (EPR II) in 1997, a chapter was included on education for the groups who are involved with looking after patients with asthma, and proposes the inclusion of questions focused on the valuation of results from the patients point of view, symptomatic improvement, concerns, quality of life and the objectives of the treatment. Over the last few years questionnaires have been designed that deal with the quality of life of asthma sufferers, that describe states of health and they also allow one to detect and quantify changes in the state of health. It has been demonstrated that the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Thermometer of General Health (Analogical Visual Scale AVS) can be used in clinical practise and in clinical tests to evaluate paediatric patients who have sufficient capacity to read and understand. In younger children the Diary of the Asthmatic Child Carer can be used (DAC). In the Valair Study the general objective is considered to be the nalysis of the use and validity, in Spain, of the PAQLQ and the DAC during regular clinical practise situations and a series of specific objectives related to the above. ⋯ the PAQLQ and the DCA have proven to be valid instruments to measure the quality of life of the children who suffer from asthma in Spain. The values of the PAQLQ reach a high degree of correlation with the seriousness of the asthma and the exerbations over the last year, which indicates a good relation between the perception that the child has of this own quality of life and the seriousness of the asthma. Young children are capable of correctly filling in the quality of life questionnaires and it doesn't take them too much time. (ABSTRACT TRUNCATED)