Specific immunotherapy and long-term prevention of asthma in children

Allergy. 2006 Jul;61(7):855-9.

Five-year follow-up on the PAT study: specific immunotherapy and long-term prevention of asthma in children.

Niggemann B, Jacobsen L, Dreborg S, Ferdousi HA, Halken S, Host A, Koivikko A, Koller D, Norberg LA, Urbanek R, Valovirta E, Wahn U, Moller C; The PAT Investigator Group.

Department of Pediatric Pneumology and Immunology, Charite, Berlin, Germany.

Background: A 3-year course of specific immunotherapy (SIT) in children with hay fever to grass and/or birch pollen significantly reduced the risk of developing asthma. To investigate the long-term preventive effect, we performed a follow up - 2 years after termination of immunotherapy. Methods: A total of 183 children, aged 6-14 years with grass and/or birch pollen allergy could be investigated 2 years after discontinuation of SIT or no treatment. Conjunctival provocation tests (CPTs) and methacholine bronchial provocation tests were carried out during the season and winter after 5 years. The development of asthma was assessed by clinical evaluation. Results: The significant improvement in hay fever and CPT results observed after 3 years of SIT persisted at the 5-year follow-up. No difference in bronchial responsiveness to methacholine was found after 5 years because of spontaneous improvement during the follow-up period in the control patients. The immunotherapy-treated children had significantly less asthma after 5 years as evaluated by clinical symptoms [odds ratio 2.68 (1.3-5.7)] in favor of SIT for prevention of development of asthma and significantly less patients reported an increase in asthma scores (P < 0.01). Conclusion: Immunotherapy for 3 years with standardized allergen extracts of grass and/or birch shows long-term clinical effect and preventive effect on development of asthma in children with seasonal rhinoconjunctivitis.

PMID: 16792584 [PubMed - in process]

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