Ist die subkutane Immuntherapie (SCIT) Schnee von gestern?

Zusammenfassung

Auf der Suche nach aktuellen Daten zur Wirksamkeit der spezifischen Immuntherapie bei allergischer Rhinitis oder Asthma bronchiale im Kindes- und Jugendalter stößt man fast ausschließlich auf Studien, welche die sublinguale Applikationsform (SLIT) untersucht haben. Arbeiten zur subkutanen Applikationsform (SCIT) finden sich nur in geringer Zahl. Ist die SCIT aufgrund fehlender Evidenz damit Schnee von gestern? Bei indirekten Vergleichen zur Wirksamkeit beider Therapieformen schneidet die SCIT eher besser ab als die SLIT. Zudem bestehen Unsicherheiten über eine ausreichende Adhärenz und Compliance bei der SLIT im Kindes- und Jugendalter. Das Dilemma zwischen einer rein evidenzgetriebenen Betrachtungsweise und dem über Jahrzehnte bewährten Therapieprinzip der SCIT lässt sich womöglich nur lösen, indem für die spezifische Immuntherapie im Kindes- und Jugendalter separate Leitlinien formuliert werden.

Summary

Clinical trials addressing the efficacy of specific immunotherapy in children and adolescents with allergic rhinitis or asthma focus predominantly on the sublingual administration route (SLIT). In contrast, data about subcutaneous immunotherapy (SCIT) in this age group are sparse. Is subcutaneous immunotherapy yesterday’s chip paper? Indirect comparison of the efficacy favors SCIT over SLIT. Moreover, compliance and adherence might be better in SCIT compared to SLIT, especially in children and adolescents. An approach which considers only the highest level of evidence might therefore underestimate the effectiveness of a proven and possibly superior therapy, namely SCIT. This dilemma might be solved by separate pediatric guidelines for the use of specific immunotherapy in children and adolescents.

Schlüsselwörter

Allergische Rhinitis - Asthma bronchiale - spezifische Immuntherapie

Keywords

Allergic rhinitis - asthma - specific immunotherapy

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