Abstract
BackgroundTemperate grass (eg, ryegrass) pollen is a major driver of seasonal allergic rhinitis (SAR) and asthma risks, including thunderstorm asthma. Data for the effectiveness of temperate grass pollen allergen immunotherapy (AIT) in SAR patients from the southern hemisphere, who are frequently polysensitized to subtropical grass pollens, are limited. The 300 IR 5-grass pollen sublingual immunotherapy tablet (300 IR 5-grass SLIT) is known to be effective in polysensitized SAR patients with primary allergy to temperate grasses, however, the influence of polysensitization to subtropical grass pollen on treatment responses has yet to be specifically addressed. Key aims of this study were to measure patient treatment satisfaction during 300 IR 5-grass SLIT treatment and evaluate how polysensitization to subtropical grass pollens affects treatment responses.MethodsA prospective observational study was conducted in 63 patients (aged ≥5 years) in several temperate regions of Australia prescribed 300 IR 5-grass SLIT for SAR over 3 consecutive grass pollen seasons. Ambient levels of pollen were measured at representative sites. Patient treatment satisfaction was assessed using a QUARTIS questionnaire. Rhinoconjunctivitis Total Symptom Score (RTSS) and a Hodges-Lehmann Estimator analysis was performed to evaluate if polysensitization to subtropical grass pollen affected SAR symptom intensity changes during SLIT.ResultsA diagnosis of ryegrass pollen allergy was nearly universal. There were 74.6% (47/63) polysensitized to subtropical and temperate grass pollens. There were 23.8% (15/63) monosensitized to temperate grass pollens. From the first pollen season, statistically significant improvements occurred in SAR symptoms compared with baseline in both monosensitized and polysensitized patients, particularly in those polysensitized (P = 0.0297). Improvements in SAR symptoms were sustained and similar in both groups in the second and third pollen seasons, reaching 70–85% improvement (P < 0.01). Polysensitized patients from both northerly and southerly temperate regions in Australia showed similar improvements. Grass pollen counts in both regions were consistently highest during springtime.Conclusions300 IR 5-grass SLIT is effective in a real-life setting in SAR patients in the southern hemisphere with primary allergy to temperate grass pollen and predominantly springtime grass pollen exposures. Importantly, SLIT treatment effectiveness was irrespective of the patient's polysensitization status to subtropical grass pollens.
Highlights
In temperate regions of Australia, and in similar climatic regions globally, pollens from temperate grasses are major drivers of seasonal allergic rhinitis (SAR) and asthma risks, including epidemic thunderstorm asthma.[1–4]The effectiveness of temperate grass pollen allergen immunotherapy (AIT) has been wellcharacterized in SAR populations from the northern hemisphere, with evidence available from a number of large, double-blind, placebocontrolled, randomized trials for the short- and long-term treatment benefits of standardized AIT products.[5]
300 Index of Reactivity” (IR) 5-grass SLIT is effective in a real-life setting in SAR patients in the southern hemisphere with primary allergy to temperate grass pollen and predominantly springtime grass pollen exposures
One controlled study of grass pollen AIT effectiveness in Australian SAR patients has been performed, which was an open-label, controlled study conducted with 300 IR 5-grass pollen sublingual immunotherapy tablet (300 IR 5-grass SLIT), which contains a homologous mixture of temperate grass pollens including ryegrass pollen.[6]
Summary
In temperate regions of Australia, and in similar climatic regions globally, pollens from temperate grasses (such as ryegrass) are major drivers of seasonal allergic rhinitis (SAR) and asthma risks, including epidemic thunderstorm asthma.[1–4]The effectiveness of temperate grass pollen allergen immunotherapy (AIT) has been wellcharacterized in SAR populations from the northern hemisphere, with evidence available from a number of large, double-blind, placebocontrolled, randomized trials for the short- and long-term treatment benefits of standardized AIT products.[5]. In temperate regions of Australia, and in similar climatic regions globally, pollens from temperate grasses (such as ryegrass) are major drivers of seasonal allergic rhinitis (SAR) and asthma risks, including epidemic thunderstorm asthma.[1–4]. There have been comparatively few studies of the effectiveness of temperate grass pollen AIT treatments in SAR patients from the southern hemisphere, who are frequently polysensitized to both temperate and subtropical grass pollens.[1,2]. Data for the effectiveness of temperate grass pollen allergen immunotherapy (AIT) in SAR patients from the southern hemisphere, who are frequently polysensitized to subtropical grass pollens, are limited. The 300 IR 5-grass pollen sublingual immunotherapy tablet (300 IR 5-grass SLIT) is known to be effective in polysensitized SAR patients with primary allergy to temperate grasses, the influence of polysensitization to subtropical grass pollen on treatment responses has yet to be addressed. Key aims of this study were to measure patient treatment satisfaction during 300 IR 5-grass SLIT treatment and evaluate how polysensitization to subtropical grass pollens affects treatment responses
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