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Component-resolved diagnosis may modify need for immunotherapy

Component-resolved diagnoses among children with pollen-related allergic rhinitis modified clinical decisions to prescribe specific immunotherapies, according to data recently published in the Journal of Allergy and Clinical Immunology.

“In a clinic-based population of 651 Italian children with pollen-related [allergic rhinitis], we found that the measurement of serum specific IgE levels to the major allergenic molecules of pollens (CRD) can very frequently modify the decision to provide allergen-specific [immunotherapy] SIT based on the same clinical information and clinical history integrated with [skin prick test] responses with pollen extracts,” Giovanna Stringari, MD, of the Charité Medical University in Berlin, and the University of Parma, and colleagues wrote. “These results were obtained not only by applying [four] different theoretic prescription and pragmatic models for prescribing SIT but also by asking 14 local pediatric allergists for their opinions on SIT prescription in each patient.”

They researchers did not find IgE levels to respective allergens in a significant amount of patients with clinically relevant sensitizations to mugwort (69%), Betulaceae (60%), pellitory (30%), olive (28%), cypress (15%), and grass (10%), according to data. IgE to profilins, polcalcins, or both, however, could justify 173 (37%) of 464 of the skin prick test responses, they wrote.

Skin prick test-based decisions with consideration for CRD, modified whether or not clinicians prescribed SIT among 42% of the patients using the European approach, and 48% according to the American approach, the researchers wrote. This was also the case among 47% of the patients, based on opinions by the consulted pediatric allergists.

These findings may be useful for future updates to the national and international guidelines on prescriptions of immunotherapies for patients with pollen-related allergic rhinitis, the researchers concluded.

Disclosure: See the study for a full list of relevant financial disclosures.