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Efficacy of grass pollen sublingual immunotherapy for three consecutive seasons and after cessation of treatment: the ECRIT study
Author(s) -
Ott H.,
Sieber J.,
Brehler R.,
FölsterHolst R.,
Kapp A.,
Klimek L.,
Pfaar O.,
Merk H.
Publication year - 2009
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2008.01875.x
Subject(s) - slit , placebo , sublingual immunotherapy , medicine , sublingual administration , pollen , adverse effect , allergy , randomized controlled trial , anesthesia , immunology , botany , biology , allergen , pathology , genetics , alternative medicine
Background: Data supporting a carry‐over effect with sublingual immunotherapy (SLIT) are scarce. This randomized, double‐blind, placebo‐controlled study evaluated the efficacy, carry‐over effect and safety of grass pollen SLIT using co‐seasonal treatment. Methods: Patients (7.9–64.7 years) with grass pollen allergy received ultra‐rush titration with increasing doses (30, 90, 150 and 300 IR) of a 5‐grass pollen mixture every 20 min at the start of the pollen seasons, followed by 300 IR daily until the end of the pollen seasons. A baseline season (no SLIT) was followed by three consecutive treatment seasons and one follow‐up season. Symptoms, medication and adverse events were documented and specific immunoglobulin (Ig)E and IgG 4 measured. Results: Data were analysed for 183 of the 213 randomized patients. Mean treatment duration varied between seasons (81.8−92.7 days). Combined scores (symptoms and medication) improved progressively across treatment seasons (up to 44.7% improvement for SLIT compared with baseline) and fluctuated between −11.3% and −14.8% for placebo ( P < 0.05). Similar changes were observed for symptom scores, with a successive decrease of 39.7% (SLIT) and fluctuations between +13.6% and −1.51% for placebo ( P < 0.05). Combined score ( P = 0.0508) and symptom score improvements ( P = 0.0144) with SLIT continued during follow up. Increases in specific IgG 4 observed in the first season were sustained for SLIT vs placebo throughout treatment ( P = 0.0001). Titration and daily SLIT were well tolerated. No serious systemic or anaphylactic reactions were reported. Conclusions: Seasonal SLIT with ultra‐rush titration is well tolerated and effective from the first treatment season onwards. These data indicate a carry‐over effect of seasonal SLIT.