In allergic children with asthma or rhinitis, is immunotherapy useful?

Authors’ conclusions: There is at present insufficient evidence that immunotherapy in any administration form has a positive effect on symptoms and/or medication use in children and adolescents with allergic rhino conjunctivitis.

In allergic asthma, the subcutaneous immunotherapy appears to reduce symptoms and use of medication but the evidence is limited concerning the size of benefit. It is not free of side effects. High dose sublingual immunotherapy produces symptomatic improvement and decreases the medication use in children with asthma and allergies to grass pollen.

Reviewers’ commentary: The prevalence of allergic diseases is increasing, and its burden is substantial. The efficacy of the treatment with allergen-specific immunotherapy has not been demonstrated; although the improvement has statistical significance, the clinical relevance is poor, with an increased risk of adverse reactions. Due to that, the use of immunotherapy should not be generalised, reserving it for cases thoroughly evaluated.