Creation of an international Inter-Society Pediatric Allergology Network (ISPAN): preliminary data from a survey of pediatric allergist in Italy, Spain, and Portugal

Allergic rhinitis and asthma are among the most important chronic diseases in children and young adults, with increasing prevalence and significant impact on the healthcare system and quality of life. Allergen Immunotherapy (AIT) remains the only causal treatment capable of modifying the natural course of allergy. However, despite its proven efficacy, real-world data on its application in the pediatric population remain limited. This study aimed to evaluate and compare the management and clinical practice of allergic diseases in the pediatric population, particularly the current use of AIT for respiratory allergy, by pediatricians and allergists in Italy, Spain, and Portugal. A comprehensive online survey developed by the pediatric allergy societies of the three countries was distributed to pediatric allergists to collect demographic data, diagnostic and treatment approaches, and AIT prescription attitudes. A total of 171 responses were analyzed in this study. The results show that most allergists treat high numbers of pediatric allergic patients on weekly basis, primarily using skin and laboratory tests for diagnosis of allergy, and pulmonary function tests to diagnose asthma. AIT was prescribed by the majority of allergists (91.2%), primarily for children aged ≥5 years, and mainly for allergic rhinoconjunctivitis and asthma. Of the respondents, 64.1% chose sublingual AIT over subcutaneous AIT (35.9%) because of compliance (77.6%) or practical reasons (67.9%). Patients were mainly treated for 3 years (39.7%) to 5 years (21.2%) and were regularly monitored every 6 months (51.3%). This initiative marks the first multinational collaboration between pediatric national allergology societies in Mediterranean countries, establishing a fundamental network for future collaborations. This study provides valuable insights and encourages further efforts to harmonize pediatric allergy care across similar sociocultural and environmental regions.