Background Sublingual immunotherapy (SLIT) consistently ameliorates pediatric allergic rhinitis (AR); the developmental stage-dependent efficacy remains equivocal. This study interrogated whether symptomatic improvement after SLIT differs among preschool, prepubertal, and pubertal cohorts. Methods We enrolled children with AR (aged 4–14 years) receiving SLIT and stratified them into three age groups: preschool (4–6 years), prepubertal (7–9 years), and pubertal (10–14 years). Nasal symptoms and total nasal symptom scores (TNSS) were evaluated at baseline and at different time points during treatment. Results A total of 134 patients were included (71 preschool, 41 prepubertal, 22 pubertal). All age groups showed significant improvement in nasal symptoms post-SLIT (P < 0.05), but a pronounced “younger-age advantage” was observed. Preschool (4–6 years) children experienced a 14.4% greater improvement in TNSS at 12 months compared to pubertal children (P < 0.05). The preschool and prepubertal groups achieved rapid symptom relief within 12 months, with subsequent stabilization, whereas the pubertal group required 24 months to attain comparable efficacy and exhibited poorer control of nasal itching. Conclusions SLIT efficacy in pediatric AR is age-dependent, with younger patients deriving greater benefits and pubertal patients requiring extended treatment duration (≥3 years). These findings support age-stratified therapeutic strategies and provide critical evidence for personalized SLIT regimens. Impact <UnorderedList Mark="Bullet"> <ItemContent> This study reveals that SLIT efficacy for pediatric allergic rhinitis is age-dependent, with younger children (preschool and prepubertal) experiencing faster and more significant symptom improvement compared to pubertal children. </ItemContent> <ItemContent> It highlights the need for age-stratified treatment strategies, suggesting that SLIT should be prioritized for preschool children to prevent disease progression and that pubertal patients may require extended treatment duration (≥3 years) and adjunctive therapies for optimal outcomes. </ItemContent> <ItemContent> These findings fill a critical knowledge gap regarding age-specific responses to SLIT and provide evidence-based support for personalized treatment regimens in pediatric allergic rhinitis management. </ItemContent> </UnorderedList>

Age-stratified evaluation of sublingual immunotherapy outcomes in children with allergic rhinitis

期刊论文
发表日期：

2026年4月13日

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Xiangqian Qiu,
Junjie Qin,
Yinhui Zeng,
Tong Wang,
Wenlong Liu

摘要

Background

Sublingual immunotherapy (SLIT) consistently ameliorates pediatric allergic rhinitis (AR); the developmental stage-dependent efficacy remains equivocal. This study interrogated whether symptomatic improvement after SLIT differs among preschool, prepubertal, and pubertal cohorts.

Methods

We enrolled children with AR (aged 4–14 years) receiving SLIT and stratified them into three age groups: preschool (4–6 years), prepubertal (7–9 years), and pubertal (10–14 years). Nasal symptoms and total nasal symptom scores (TNSS) were evaluated at baseline and at different time points during treatment.

Results

A total of 134 patients were included (71 preschool, 41 prepubertal, 22 pubertal). All age groups showed significant improvement in nasal symptoms post-SLIT (P < 0.05), but a pronounced “younger-age advantage” was observed. Preschool (4–6 years) children experienced a 14.4% greater improvement in TNSS at 12 months compared to pubertal children (P < 0.05). The preschool and prepubertal groups achieved rapid symptom relief within 12 months, with subsequent stabilization, whereas the pubertal group required 24 months to attain comparable efficacy and exhibited poorer control of nasal itching.

Conclusions

SLIT efficacy in pediatric AR is age-dependent, with younger patients deriving greater benefits and pubertal patients requiring extended treatment duration (≥3 years). These findings support age-stratified therapeutic strategies and provide critical evidence for personalized SLIT regimens.

Impact

This study reveals that SLIT efficacy for pediatric allergic rhinitis is age-dependent, with younger children (preschool and prepubertal) experiencing faster and more significant symptom improvement compared to pubertal children.

It highlights the need for age-stratified treatment strategies, suggesting that SLIT should be prioritized for preschool children to prevent disease progression and that pubertal patients may require extended treatment duration (≥3 years) and adjunctive therapies for optimal outcomes.

These findings fill a critical knowledge gap regarding age-specific responses to SLIT and provide evidence-based support for personalized treatment regimens in pediatric allergic rhinitis management.