Efficacy and safety of sublingual immunotherapy with grass monomeric allergoid: comparison between two different treatment regimens.

Abstract

BACKGROUND:

Sublingual immunotherapy (SLIT) with monomeric carbamylated allergoid proved to be well tolerated, safe and effective in patients with respiratory allergy. Standard administration regimens are expected to require a long time before clinical benefit can be appreciated. We investigated whether pre-seasonal and perennial regimens differently affect the clinical efficacy of grass pollen SLIT.

METHODS:

Adult patients with allergic rhino-conjunctivitis with/without mild intermittent asthma due to grass pollen were included into this open prospective study and randomised to receive SLIT with a continuous regimen (Group 1: 1,000 AU/week for the entire study period) or a pre-seasonal regimen (Group 2: 5,000 AU/week for 10 weeks/year for 2 years), or on demand drug therapy alone (Group 3) for two years. At entry (November 2005), at the end of the first and second pollen season, a Visual Analogue Scale (VAS) was used to assess patients' well-being. Symptom score and drug consumption were evaluated during the seasons. Methacholine challenge was performed at study entry and conclusion. Adverse events were recorded along the whole study duration.

RESULTS:

Thirty-two patients were divided into Group 1 (n = 10), Group 2 (n = 11) and Group 3 (n = 11). A significant VAS improvement was observed in both SLIT groups, after the first and second pollen season, compared to baseline and to Group 3 (p < 0.05). Less symptoms and need for medications resulted during the second season (p < 0.05). No relevant variations in bronchial hyper-reactivity have been observed between the three groups. Only 2 patients experienced local or mild reactions in SLIT groups.

CONCLUSION:

Both pre-seasonal and continuous regimen of SLIT with monomeric allergoid turned out effective and safe, suggesting that a pre-seasonal course with 5,000 AU/week for 10 weeks may represent a convenient option in patients with grass pollen allergic rhinitis with/without mild intermittent asthma. Further research is urgently needed to consolidate these preliminary evidences.

• Authors: O Quercia, M E Bruno, E Compalati, P Falagiani, G Mistrello, G F Stefanini
• Journal: European annals of allergy and clinical immunology (Eur Ann Allergy Clin Immunol) Vol. 43 Issue 6 Pg. 176-83 (Dec 2011) ISSN: 1764-1489 [Print] Italy
• PMID: 22360134 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Allergoids
• Antigens, Plant
• Carbamates
• Plant Extracts
• Methacholine Chloride

Topics

• Administration, Sublingual
• Adult
• Aged
• Allergoids
• Antigens, Plant (administration & dosage, adverse effects, chemistry)
• Asthma (therapy)
• Carbamates (chemistry)
• Clinical Protocols
• Conjunctivitis, Allergic (therapy)
• Desensitization, Immunologic (methods)
• Female
• Humans
• Italy
• Male
• Methacholine Chloride (administration & dosage)
• Middle Aged
• Plant Extracts (administration & dosage, adverse effects, chemistry)
• Poaceae (immunology)
• Prospective Studies
• Rhinitis, Allergic, Seasonal (therapy)
• Seasons
• Treatment Outcome