Selecting children with allergic rhinitis/asthma for immunotherapy

S7C - Potpourri
SELECTING CHILDREN WITH ALLERGIC RHINITIS/ASTHMA FOR IMMUNOTHERAPY

Hugo Van Bever
National University Children's Medical Institute, National University Hospital, Singapore

Specific immunotherapy (SIT) in Asian children is focused on treating house dust mite allergy, being the most common allergy in Asian children, causing a diverse spectrum of clinical symptoms (while pollen allergy is extremely rare in Asian children). Currently, for house dust mite allergy sublingual immunotherapy (SLIT) is used, and has replaced subcutaneous immunotherapy. For food allergy oral immunotherapy (OIT) is still the preferred type of immunotherapy. 

The talk will cover SLIT, which has now become part of the treatment of many children with allergic rhinitis/conjunctivitis, allergic asthma and atopic dermatitis. Considering both efficacy and safety, SLIT is more favourable than SCIT, which may serve as a decision-making reference for clinicians. The challenge for clinicians is on selecting patients who will benefit from SLIT. In other words, 1. patients in whom the symptoms are specifically caused by the allergen (i.e., house dust mite) and 2. who are at risk not to outgrow their allergy. Criteria for patient selection for SLIT will be covered, and the profile of the young child at risk for persistent allergy will be discussed.