Treatment Course And Compliance Of Sublingual Immunotherapy In Children With Asthma

Objective: By comparing the efficacy of different courses of sublingual immunotherapy(SLIT)in children with asthma,and analyzing SLIT compliance and its influencing factors,we discussed the optimal treatment duration and how to improve children’s SLIT compliance.Methods: The clinical data of asthma children who received SLIT in the outpatient department of Children’s Hospital of Chongqing Medical University from January 1,2014 to December 31,2018 were collected.The SLIT duration,asthma symptoms after stopping SLIT,adverse reactions and stopping reasons were followed up.A total of 134 children were enrolled.According to the treatment time of SLIT,the patients were divided into 1-year group(SLIT time ≤1 year),2-year group(1 year < SLIT time ≤2 years),3-year group(2 years < SLIT time ≤3 years)and over 3years group(SLIT time > 3 years).By comparing the medication scores(MS)and asthma symptom scores(ASS)before and after the treatment of different SLIT courses,the reasons and influencing factors of stopping SLIT were analyzed,we discuss the optimal treatment duration and the SLIT compliance.Results: Among 134 cases,MS before and after SLIT treatment in one-year group has no significant differences(P>0.05).The MS in 2-year group,3-year group and over 3 years group after SLIT were significantly lower than baseline(P<0.05).In baseline period,there was no significant difference in MS under different treatment courses(P>0.05).There was no significant difference in MS and ASS between groups under different SLIT treatment courses(P>0.05).The compliance rate of SLIT at 2 years was29.10% and 14.18% at 3 years.The reasons for stopping SLIT were symptomatic relief(46.27%),poor/average effect(36.57%),inconvenience(19.74%),adverse reactions(2.99%),high medical cost(0.75%),uncooperative children(2.99%)and long course(1.49).The compliance of children under 6 years old(40%)was better the children over 6 years old(21.5%),and the difference was statistically significant(P<0.05).Sex,allergic rhinitis,family history of allergic diseases,adverse reactions and monosensitivity/polysensitivity had no significant effect on the SLIT compliance of children(P>0.05).Conclusion: Asthmatic children with more than one year’s SLIT course can reduce asthma medication,but the overall compliance is low,and the best course of treatment is controversial.The main reasons for stopping it are symptomatic relief,poor/average efficacy and inconvenience,etc.Children under 6 years old have better compliance,which may be related to parents’ assistance in management.Compliance is related to disease characteristics,treatment plan,family management and doctor-patient communication.Strengthen the propaganda of asthma and SLIT,establish a good communication channel between doctors and patients,and improve its clinical efficacy and convenience,so as to improve children’s SLIT compliance.