Abstract
BackgroundAllergy to olive pollen is one of the primary causes of allergic asthma in Spain. Even though allergen immunotherapy (AIT) has shown clinical benefits in patients sensitized to different allergens, studies in asthmatic patients sensitized to olive pollen are insufficient. ObjectiveTo assess the effectiveness and safety of an ultra-short course of AIT with an L-tyrosine-adsorbed and monophosphoryl lipid A-adjuvanted olive pollen and olive/grass pollen extract (Pollinex Quattro®) in patients with allergic asthma in the real-world setting. MethodsRetrospective, controlled study including patients with asthma, with and without allergic rhinitis, caused by sensitization to olive pollen from 11 centers in Spain. Patients received out-of-season (October–March) treatment with AIT in addition to their pharmacological treatment (active group) or pharmacological treatment (control group). Effectiveness variables, including unscheduled visits to the healthcare center, emergency room admissions, symptoms of asthma and rhinitis (following GEMA and ARIA classifications, respectively), and use of medication to treat asthma and rhinitis during the subsequent pollen season were compared between treatment groups. ResultsOf 131 study patients, 42 were treated with their usual asthma medication (control group) and 89 were treated with AIT (active group), either Pollinex Quattro® 100% olive pollen (n = 43, 48.3%) or 50% olive pollen/50% grass pollen (n = 46, 51.7%). Patients’ demographic and clinical characteristics were similar between groups. The mean (SD) number of unscheduled visits to a healthcare center and emergency room admissions due to allergy symptoms was 2.19 (1.40) and 0.43 (0.63) in the control group, and 1.09 (1.25) and 0.11 (0.51) in the active group (P = 0.001 and P = 0.006, respectively). Severity and control of asthma symptoms remained unchanged (P = 0.347 and P = 0.179, respectively), rhinitis type improved (P = 0.025), and severity remained unchanged in the active compared to the control group. The use of short-acting beta-agonists and inhaled corticosteroids to treat asthma symptoms decreased in the active vs. the control group (P = 0.001 and P = 0.031, respectively). Twelve (13.5%) and two (2.2%) patients in the active group experienced local adverse reactions (edema, swelling, erythema, hives, pruritus, and heat), and systemic adverse reactions (hypertensive crisis and low-grade fever) to AIT, respectively; none was serious. ConclusionAIT with Pollinex Quattro® specific for olive pollen and olive/grass pollens resulted in reduced visits to the healthcare center and emergency room and the use of asthma medication during the pollen season, indicating that this treatment was safe and effective in treating asthma in patients sensitized to these pollens.
Highlights
Patients’ demographic and clinical characteristics are summarized in Table 1 and were similar between treatment groups (P; not significant), with the exception of rhinitis diagnosis and sensitization to molds, with a significantly different prevalence between the control and active groups (P 1⁄4 0.019 and P 1⁄4 0.002, respectively)
Regarding allergen immunotherapy (AIT) composition, 43 (48.3%) and 46 (51.7%) patients were administered Pollinex QuattroÒ composed of 100% olive pollen and Pollinex QuattroÒ composed of 50% olive pollen/50% grass pollen, respectively
Delayed local reaction of diameter 1 Patient recovered without treatment 10 cm. In this retrospective controlled study including patients with allergic asthma sensitized to olive pollen, with and without allergic rhinitis, we provided real-world evidence regarding the effectiveness and safety of Pollinex QuattroÒ
Summary
Asthma is a chronic inflammatory disorder of the airways with an estimated prevalence of 1%–18% in different countries, affecting 300 million people worldwide, and is the most common chronic disease in children.[1,2] Allergic asthma, the most frequent form of asthma, is commonly associated with allergic rhinitis and usually caused by sensitization to pollen grains, which may trigger asthma exacerbations.[3,4]Sensitization of patients to different pollens varies regionally, being allergy to olive pollen prevalent in the Mediterranean area.[5,6,7,8] In Spain, sensitization to olive pollen is, after grass pollen, the second cause of allergic asthma, and polysensitization to both pollens is frequent.[9,10] In different regions with different predominant pollens, in each pollen season, increased pollen counts and/or pollen allergen concentrations (i.e., pollen peaks) have been associated with increased burden of asthma.[11,12] compared to other pollens, olive pollen has shown a greater allergenic potency and a stronger association with disease exacerbation in asthmatic patients.[13]. Asthma is a chronic inflammatory disorder of the airways with an estimated prevalence of 1%–18% in different countries, affecting 300 million people worldwide, and is the most common chronic disease in children.[1,2] Allergic asthma, the most frequent form of asthma, is commonly associated with allergic rhinitis and usually caused by sensitization to pollen grains, which may trigger asthma exacerbations.[3,4]. Allergy to olive pollen is one of the primary causes of allergic asthma in Spain. Even though allergen immunotherapy (AIT) has shown clinical benefits in patients sensitized to different allergens, studies in asthmatic patients sensitized to olive pollen are insufficient
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