SQ sublingual immunotherapy tablets for children with allergic rhinitis: A review of phase three trials

• Published in: Acta Paediatrica 2024-06, Vol.113 (6), p.1209-1220
• Main Authors: Csonka, Péter, Hamelmann, Eckard, Turkalj, Mirjana, Roberts, Graham, Mack, Douglas P.
• Format: Article
• Language: English
• Subjects: Administration, Sublingual; Adolescent; Adolescents; Allergic rhinitis; Asthma; Asthma - therapy; Child; Children; Clinical trials; Clinical Trials, Phase III as Topic; Hay fever; Humans; Immunotherapy; Oral administration; paediatric; Placebos; randomised controlled trials; Randomized Controlled Trials as Topic; Rhinitis; Rhinitis, Allergic - therapy; Rhinoconjunctivitis; sublingual allergy immunotherapy tablets; Sublingual Immunotherapy - methods; Tablets
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/apa.17221

Aim To provide paediatricians with a summary of efficacy and safety of SQ sublingual immunotherapy (SLIT) tablets from phase three, randomised, double‐blind, placebo‐controlled trials in children and adolescents with allergic rhinitis or rhinoconjunctivitis, with and without asthma. Methods PubMed searches were conducted and unpublished data were included if necessary. Results Of the 93 publications, 12 were identified reporting 10 trials. One trial was excluded as paediatric‐specific efficacy data were unavailable. The nine eligible trials evaluated grass, house dust mite, ragweed and tree SLIT tablets. Consistent reductions in allergic rhinitis or rhinoconjunctivitis symptoms and medication use were observed with SQ SLIT tablets versus placebo. In a five‐year trial, sustained reduction of allergic rhinoconjunctivitis symptoms, asthma symptoms and medication use were observed with SQ grass SLIT tablet versus placebo. The number‐needed‐to‐treat to prevent asthma symptoms and medication use in one additional child during follow‐up was lowest in younger children. SQ SLIT tablets were generally well tolerated across trials. Conclusion Evidence supports use of SQ SLIT tablets in children and adolescents with allergic rhinitis or rhinoconjunctivitis, with and without asthma. Long‐term data demonstrate disease‐modifying effects of SQ grass SLIT tablet and suggest the clinical relevance of initiating allergy immunotherapy earlier in the disease course.