Safety and tolerability of SLIT in allergic children
The overall safety of SLIT has been widely provenand accepted. Though the safety profile should bedemonstrated for the single extract of each brand, life threatening and non-life-threatening severe systemicadverse events (SAEs) related to SLIT are very rare .Among double blind-placebo controlled-randomizedclinical trials (DB-PC-RCTs) for allergic asthma, allergicrhinitis or allergic rhino-conjunctivitis involving children, one reports the use of epinephrine. In one patient, enrolled in the placebo group, epinephrine was given at the investigational site because of wheezing ,probably related to previous exposure to a grassy field according to the investigators. Within the active group, an inappropriate administration of epinephrine occurred in the emergency department where the patient was later diagnosed with viral pharyngitis. Another patient experienced a SLIT-related non life threatening systemic reaction after the first dose of grass AIT (tablet). Epinephrine was administered but the investigator graded the severity of the event as moderate. In the real-life setting, five cases of SLIT related SAEs described as anaphylaxis have been published (Table 3). In two of them, epinephrine was administered.