Subcutaneous Allergen Immunotherapy in Children: Real Life Compliance
and Effect of COVID-19 Pandemic on Compliance
Background: Allergen immunotherapy(AIT) is an effective treatment for
allergic rhinitis, asthma and venom allergy. Compliance is essential for
AIT to obtain maximal benefit as it is a long term treatment. Objective:
We aimed to evaluate the real life compliance of children with
subcutaneous immunotherapy(SCIT) and tried to document the factors
associated. Additionally how COVID-19 pandemic effected the compliance
of the patients and the reasons of drop-outs were also evaluated.
Method: Patients diagnosed with allergic rhinitis, allergic asthma or
venom allergy and treated with SCIT between 2012 September, 2020 July
were analyzed. Results: The study population comprised of 201 children
(66,7% male) with a median (interquartile range) age of 12,8(9,4-15,2)
years during the first injection of SCIT. The overall compliance rate
before COVID-19 pandemic was 86,1%. Short AIT follow up time and venom
allergy were found to be risk factors for drop out. The leading causes
of drop outs were moving to another city/country(32,1%), improvement of
symptoms(17,8%), ineffectiveness(14,2%) and adverse reactions(14,2%).
During COVID-19 pandemic, among 108 patients receiving AIT, 31(28,7%)
dropped out the therapy. The most frequent reasons for drop-outs were
fear of being infected with COVID-19(35,4%) and thinking that the AIT
practise stopped due to COVID-19 pandemic(29%). Male gender and older
age were found to be the independent risk factors for drop out.
Conclusion: The real life compliance in children was higher than in
adults. Nearly one third of children dropped out during COVID-19
pandemic. Male gender and older age are associated with AIT drop out
during COVID-19 pandemic.