Kurzzeit-Immuntherapie mit Baumpollen-Allergoiden und dem Adjuvans Monophosphoryl Lipid-A – Ergebnisse einer randomisierten, doppelblinden, plazebokontrollierten Multicenterstudie

Abstract

Specific immunotherapy (SIT) is considered as the only causal treatment of IgE-mediated allergies apart from allergen avoidance. In this randomized, placebo-controlled, double-blind study, efficacy and tolerability of a preseasonal short-term immunotherapy with 4 injections was evaluated in patients with tree-pollen allergy. Eighty-four patients with clinically relevant seasonal allergic rhinitis, conjunctivitis and/or asthma sensitised to birch/alder/hazel pollen were enrolled. The active group received 4 injections of L-tyrosine-adsorbed tree pollen allergoids plus 50 μg/ml monophosphoryl lipid-A (MPL; n = 57). The placebo injections consisted ofL-tyrosine-solution (2%) in excipient solution (n = 27). The combined symptom-/medication score served as a primary endpoint. Changes in skin reactivity measured by titrated skin prick test and blood levels of pollen-specific IgG and IgE antibodies served as secondary endpoints. There was a significant advantage in favour of the active treatment for the combined symptom-/medication score (p = 0.028). Titrated skin prick testing revealed a significant reduction of skin sensitivity after therapy (p < 0.01) and a significant decrease of mean sum of wheal areas in the active group compared to placebo (p = 0.03). Already 2 weeks after active treatment, levels of specific IgG rose significantly (p < 0.01). An increase of specific IgE during and after pollen season was only observed in the placebo group (p < 0.01). The tolerability of the therapy was good. There were no reports of serious or severe adverse events. In this study, the efficacy and tolerability of a short-term immunotherapy with 4 injections was shown. The application of this short-term therapy may improve acceptance by patients and encourage wider application of SIT in the treatment of IgE-mediated allergies.