Corticosteroids sparing effect of artemisia annua sublingual immunotherapy: A prospective study in pediatric seasonal allergic rhinoconjunctivitis (INCs sparing and efficacy of Artemisia annua SLIT in pediatric SARC).

PURPOSE: This study aimed to evaluate the efficacy and safety of Artemisia annua sublingual immunotherapy (SLIT) in pediatric patients with seasonal allergic rhinoconjunctivitis (SARC), and its specific impact on assessing the reduction in intranasal corticosteroids (INCs) use for individual patients. METHODS: Sixty pediatric patients (aged 3–17 years) with SARC were recruited at the Department of Otolaryngology of the First Affiliated Hospital of Xi’an Jiaotong University from February to August 2023. Participants were randomly allocated to either the SLIT group (n = 30) or the control group (n = 30). The SLIT group received Artemisia annua-SLIT with symptomatic medication while the control group received symptomatic medication only. The study continued until October 2024. Four nasal symptom scores, two eye symptom scores, and medication usage of the patients during 2022 (baseline), 2023 and 2024 pollen seasons were recorded, as well as adverse events (AEs) during the study. RESULTS: Eighteen patients in the SLIT group and 22 in the control group completed the study. Compared to the control group, the SLIT group demonstrated significantly lower scores for the total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), visual analogue scale (VAS), and the combined symptom and medication score (CSMRS) throughout both the 2023 and 2024 pollen seasons. Furthermore, when compared to the baseline, the SLIT group showed significant reductions in the TRSS, TMS, VAS, and CSMRS following treatment. Notably, 88.89% of patients in the SLIT group discontinued INCs use by the end of the study, and 83.33% achieved substantial clinical improvement, defined as a > 50% reduction in CSMRS. No serious AEs were observed in the SLIT group throughout the treatment period. CONCLUSIONS: Artemisia annua-SLIT administered during two consecutive pollen seasons demonstrated clinical efficacy and safety in pediatric patients with SARC and significantly reduced their dependence on INCs.