Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children

J Allergy Clin Immunol. 2011 Feb;127(2):502-508.e1-6. doi: 10.1016/j.jaci.2010.11.036.


Background: The safety and efficacy of specific immunotherapy for mold allergy are not known in children and adolescents.

Objective: We evaluated the efficacy and safety of specific immunotherapy with a standardized allergen extract in a randomized, double-blind, placebo-controlled, 3-year prospective study of patients who were allergic to only Alternaria alternata.

Methods: Fifty children and adolescents (25 girls; 5-18 years of age) with A alternata-induced seasonal allergic rhinoconjunctivitis and/or bronchial asthma were randomly assigned to groups given treatment (Novo-Helisen Depot, A alternata 100%) or placebo. The primary end point was the combined symptom medication score. Secondary end points included safety, quality of life, and sensitivity to allergen-specific nasal challenge.

Results: Forty-five children completed the 3-year study. Although there was no significant change in year 1, the combined symptom medication score decreased in years 2 and 3 of the study (by 38.7% and 63.5%, respectively; P < .001 for each). The reduction in symptoms was associated with a significant improvement in quality of life (P < .05) and decrease in sensitivity after allergen-specific nasal challenge. Side effects were observed in 7 patients; the most common (edema at the site of injection) occurred after 11 injections.

Conclusions: Allergen-specific immunotherapy with standardized A alternata extract reduces symptoms of asthma and rhinoconjunctivitis in children and adolescents without serious side effects.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Alternaria / immunology*
  • Asthma / therapy
  • Child
  • Child, Preschool
  • Conjunctivitis, Allergic / therapy
  • Desensitization, Immunologic* / adverse effects
  • Double-Blind Method
  • Female
  • Humans
  • Hypersensitivity / immunology
  • Hypersensitivity / psychology
  • Hypersensitivity / therapy*
  • Male
  • Prospective Studies
  • Quality of Life
  • Rhinitis / therapy