NICE expands access to allergy immunotherapy tablets for children as young as five
核心洞察
NICE has recommended widening eligibility for Acarizax to children aged 5–11 with severe house dust mite allergy (搜索) and Itulazax to young people aged 5–17 with birch tree pollen allergy (搜索).
More than 2,000 children across England are expected to benefit from the expanded access to these daily allergen immunotherapy tablets.
Both treatments are taken once daily for three years and aim to build immune tolerance, addressing the root cause rather than merely managing symptoms.
Thousands of children living with debilitating allergies could soon gain access to innovative daily tablet treatments after the National Institute for Health and Care Excellence (NICE) recommended widening eligibility for two therapies designed to tackle the root cause of allergic reactions.
Under the draft recommendations, Acarizax will now be available to children aged 5 to 11 with severe house dust mite allergy (搜索), while Itulazax has been approved for young people aged 5 to 17 with birch tree pollen allergy (搜索). NICE estimates that just over 2,000 children in England could benefit from the change, offering relief for those whose symptoms have not responded adequately to conventional treatments.
A shift from symptom management to disease modification
Unlike standard medications that mainly manage symptoms, both Acarizax and Itulazax work through allergen immunotherapy. Patients take a soft tablet containing a small dose of the allergen each day, helping the immune system gradually build tolerance over time. The treatments are taken daily for three years, with evidence showing they can significantly reduce allergy symptoms and lessen reliance on other medicines.
This mechanism sets them apart from medicines such as antihistamines and nasal corticosteroids, which control allergy symptoms. These remain standard treatment for allergic rhinitis (搜索), but immunotherapy is intended for children whose symptoms persist despite these medicines. Because the treatments target a specific allergen, children must have a confirmed sensitisation to it, established through a skin-prick test or a blood test for specific IgE.
Dr Robin Gore, President of the British Society for Allergy and Clinical Immunology, has previously said the approach "marks a shift from simply managing symptoms to long-term disease modification."
The burden of persistent allergies
Allergic rhinitis (搜索) affects thousands of children and young people, causing symptoms such as sneezing, an itchy nose, a blocked or runny nose, and itchy, red and watery eyes. For some patients, the condition can be far more serious, leading to fatigue, facial swelling and disrupted sleep that impacts school attendance, concentration and overall quality of life.
The condition is considered persistent when symptoms occur for at least four days a week over a month and are not controlled by standard treatments. For some children, the unmet need is high, as allergic rhinitis (搜索) can be much more disruptive than seasonal sneezing. That burden can be particularly high for children with severe tree pollen allergies. As Helen Knight, Director of Medicines Evaluation at NICE, said, severe allergy can "disrupt their work, education, and family life."
The condition can also appear alongside other allergic diseases. Allergic rhinitis (搜索) and conjunctivitis commonly occur together, while asthma may also be present.
Clinical evidence and next steps
Evidence reviewed by NICE's independent committee found that extending both treatments to younger children was more effective than standard treatment alone in reducing symptoms and decreasing the need for additional medication. The decision reflects growing recognition of the long-term benefits of allergen immunotherapy for children living with severe and persistent allergies.
Following publication of final NICE guidance, NHS England (搜索) is expected to make both treatments available within three months, providing a new treatment option for children and families struggling with difficult-to-manage allergies. Healthcare leaders believe the expanded access could help improve quality of life for thousands of young patients while reducing the broader burden of allergy-related illness on NHS services.