Table 3 Comparative effectiveness of different methods of AIT in AD in children (SLIT vs SCIT)
From: Debates in allergy medicine: specific immunotherapy efficiency in children with atopic dermatitis
CLINICAL EFFICACY | AIT (route of administration) | |
|---|---|---|
SCIT | SLIT | |
WHAT IS KNOWN? | (+) in Ig-E mediated AD | (+) in Ig-E mediated AD |
(+) in AD in combination with respiratory allergies (AR and BA) | (+) in AD in combination with respiratory allergies (AR and BA) | |
(+) to mono aeroallergens (HDM, pollen of grass and plants) | (+) to mono aeroallergens (HDM, pollen of grass and plants) | |
(+) to a mixture of aeroallergens (HDM, pollen of grass and plants) | (−) | |
Have been identified effective and ineffective doses for many allergens | Have been identified the appropriate dosages for SLIT tablets for aeroallergens (allergens of grass, ragweed and house dust mites) | |
Possibly greater efficacy (at least first year) | (−) | |
Effective when using a mixture of multiple aeroallergens | (−) to a mixture of aeroallergens (HDM, pollen of grass and plants) | |
The main duration of therapy is 3–5 years | The optimal duration of therapy is 3-4 years | |
Prevention of new sensitization and progression of respiratory allergies (AR and allergic BA) | Prevention of new sensitization and progression of allergic BA | |
Lasting effect after termination of treatment | Lasting effect after termination of treatment | |
May cause local and systemic reactions | Improved safety compared to SCIT (mostly, temporary local reactions) | |
More systemic reactions | ||
Inconvenient in use (requires special conditions: a trained expert, equipped rooms and conducting in outpatient conditions, patient’s observation) | More convenient in use compared to SCIT (can be applied at home) | |
WHAT REMAINS UNANSWERED? | The comparative efficacy compared to SLIT | The comparative efficacy compared to SCIT. Possibly less effective (at least first year) |
Possibly more effective (at least first year) | ||
Optimal dosing of SLIT in drops Optimal dosing regimens are defined only for grass, ragweed and HDM tablets | ||
The possibility of using mixtures of multiple unrelated allergens | ||
Multiple allergen mixes can be less effective. | ||