Comparison of Rinkel injection therapy with standard immunotherapy

Abstract

We compared the results of a controlled, double blind study of standard immunotherapy (SIT) in subjects with ragweed hay fever during 1980 with the results of our study of Rinkel injection therapy (RIT) in a group of subjects with ragweed hay fever in 1979. Both groups were of comparable sensitivity. During the 1980 hay fever season in Milwaukee, 20 subjects with atopic rhinitis due to ragweed pollen (eight from the 1979 group treated with RIT) were given SIT (Tr), while 14 matched subjects (eight from the 1979 placebo group) were treated with a histamine placebo (Pl). The same glycerinated aqueous ragweed extract and glycerinated histamine placebo were used in both studies. The mean cumulative dose of ragweed extract in the 1980 study was 5391 PNU (20.1 μg of antigen E [AgE]) as compared with 41.5 PNU (0.16 μg of AgE) in 1979. Results indicated a significantly lower weekly mean symptom score (SxSc) in the Tr group compared with that of the Pl group in 5 of the 6 wk that ragweed pollen was counted in 1980. Weekly mean medication score (MxSc) and physical exanination score (PESc) showed similar but less striking differences. The mean seasonal SxScs, MxScs, and PEScs of the SIT Tr group were significantly lower than those of the Pl group in 1980 as well as those of the RIT Tr group in 1979. The same indices were also significantly lower in 1980 by paired analyses in the subset of eight subjects treated in both years. RAST scores showed a significant decrease in the “after season” means in the Tr group as compared with the Pl group in 1980 but not in 1979 (analysis of covariance). We conclude that SIT is more effective than a placebo or RIT in reducing SxSc, MxSc, and PESc as well as in diminishing postseason RAST values. We cannot recommend therapy as proposed by Dr. H. J. Rinkel for clinical use at this time.