Minimum Age to Initiate Immunotherapy in a Child
How young and under what circumstances would you recommend the use of immunotherapy? I have a 15-month-old patient who started with immunotherapy at 12 months. Skin tests for mold, grass, and pollen were positive. Are patients who received immunotherapy as children more likely to have asthma remission?
My personal feeling about immunotherapy is that it should be considered at any age if the patient's asthma is severe enough to warrant immunotherapy. For patients who are allergic to relevant environmental allergens, then immunotherapy may be considered at any age if the patient's asthma is severe enough. In my experience, the use of newer medications for asthma has made it very unusual that immunotherapy would be given to any patient under the age of 4 or 6 years. The medications currently available can control most asthma in children, and immunotherapy is generally not essential.
The second part of the question asks whether patients receiving immunotherapy as children will have less asthma as adults. There are some very old data on this that were collected at a time when clinical studies were not as rigorous as they are now, and the data showed that asthma is reduced at a later age if immunotherapy is started early. For the most part, allergists do not think that the data are robust enough to recommend early immunotherapy in children with allergic rhinitis or with mild asthma with the idea that the immunotherapy will prevent asthma from developing.
How young and under what circumstances would you recommend the use of immunotherapy? I have a 15-month-old patient who started with immunotherapy at 12 months. Skin tests for mold, grass, and pollen were positive. Are patients who received immunotherapy as children more likely to have asthma remission?
My personal feeling about immunotherapy is that it should be considered at any age if the patient's asthma is severe enough to warrant immunotherapy. For patients who are allergic to relevant environmental allergens, then immunotherapy may be considered at any age if the patient's asthma is severe enough. In my experience, the use of newer medications for asthma has made it very unusual that immunotherapy would be given to any patient under the age of 4 or 6 years. The medications currently available can control most asthma in children, and immunotherapy is generally not essential.
The second part of the question asks whether patients receiving immunotherapy as children will have less asthma as adults. There are some very old data on this that were collected at a time when clinical studies were not as rigorous as they are now, and the data showed that asthma is reduced at a later age if immunotherapy is started early. For the most part, allergists do not think that the data are robust enough to recommend early immunotherapy in children with allergic rhinitis or with mild asthma with the idea that the immunotherapy will prevent asthma from developing.
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