Persistence and Reasons for Discontinuation of Subcutaneous Immunotherapy in Children with Dust Mite Allergy: A Real-World Cohort from Hangzhou, China

Objective: To investigate the present state of adherence to subcutaneous specific immunotherapy (SCIT) in children sensitized to dust mites, explore the factors contributing to the cessation of SCIT in this demographic, and provide scientific evidence aimed at improving compliance and efficacy of SCIT in pediatric patients. Methods: A retrospective analysis was conducted on clinical data of pediatric patients who received treatment at our desensitization center between January 2017 and December 2023. These children exhibited sensitivity to dust mites and were diagnosed with allergic asthma, allergic rhinitis, or other allergic diseases, subsequently undergoing SCIT therapy. The fulfillment of the SCIT regimen was evaluated, and the factors contributing to treatment cessation were analyzed. Results: A total of 680 children were included in the study. Of these, 424 children (62.35%) successfully completed the entire treatment regimen (total course ≥ 3 years), whereas 256 children (37.65%) chose to discontinue the treatment prematurely (total course < 3 years). The reasons for the cessation of SCIT, ranked from most to least common, included efficacy issues (54.69%), drug intolerance (18.75%), family-related factors (10.94%), the repercussions of the COVID-19 pandemic (6.64%), influence from other diseases (6.25%) and various other reasons. The primary reason for discontinuation within the first month was family factors (46.15%), while within six months, it was drug intolerance (40.82%), and after 6 months, efficacy issues (68.04%) became the leading cause. Conclusion: The uncertain efficacy and intolerance to the medication predominantly hinder compliance with SCIT in children, while family factors serve as the main reason for discontinuation within the first month. By enhancing parental comprehension and awareness of SCIT, standardizing operational protocols, and promptly addressing any adverse reactions, compliance with SCIT could be significantly improved. Keywords: children, house dust mite, specific immunotherapy, compliance