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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2021, Number 1

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Alerg Asma Inmunol Pediatr 2021; 30 (1)

Intralymphatic immunotherapy for the management of allergic pathologies in the pediatric patient. Systematic review of clinical trials

Martínez OBL, Pedroza M?, Contreras VFA

Language: Spanish
References: 20
Page: 5-12
PDF size: 189.15 Kb.


ABSTRACT

Introduction: Intralymphatic immunotherapy (IIL) has gained interest because of its easy approach as well as potential benefits, which include effective antigenic presentation to resident lymph node cells. However, current evidence is scarce and there are no systemic reviews of clinical trials to provide evidence of its efficacy. Objective: To conduct a systematic review of clinical trials on the usefulness of intralymphatic immunotherapy for the management of pediatric allergic diseases. Material and methods: A search was carried out in PubMed, EBSCO and ISI Web of Knowledge with the following terms, with no time or language limit: intralymphatic immunotherapy allergy. Clinical trials of IIL for allergic diseases in studies conducted exclusively or involving patients 18 years of age or younger were selected. PRISMA criteria for systematic reviews were followed. Risk of bias was assessed using the Cochrane tool. Results: Of 274 records, five studies were included, totaling 73 individuals who received placebo and 79 patients who received at least 3 doses of 1,000 SQ-U of IIL with a follow-up of 10-52 weeks. In patients with rhinitis and allergic rhinoconjunctivitis, IIL improved the nasal challenge test and decreased local and systemic symptoms. In addition, it led to a decrease in drug consumption and improvement of immunological parameters in most studies. IIL did not produce moderate to severe adverse events, only mild ones; including: itching, urticaria, inflammation at the injection site, sneezing and tiredness. Adherence to therapy was close to 100%. In patients with mild asthma the evidence is insufficient. Conclusions: IIL is an effective and safe therapeutic strategy for the treatment of allergic rhinitis and rhinoconjunctivitis that is associated with excellent adherence and requires only 3 doses to have a therapeutic effect.


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