Abstract

BackgroundSublingual immunotherapy (SLIT) is effective, tolerable, and convenient for many allergic patients. Still, real-world evidence is scarce and the aim of this study is to assess the patient reported outcome of treatment with SLIT against grass pollen allergy in a consecutive patient population.MethodsPatients (n = 329) who were confirmed to be allergic to timothy grass and had been prescribed SLIT were consecutively enrolled in the study and completed a questionnaire online or in hard copy.Results207 (62.9%) patients responded to the questionnaire. The female/male ratio was 105/102 with a mean age of 39 ± 11 years (range 19–70 years). 113 (55%) patients reported they had completed the full 3-year treatment period, 49 (24%) were still on treatment, and 45 (22%) had discontinued treatment prematurely. Respondents who had completed the full treatment period reported that their allergy symptoms in the most recent grass pollen season had improved to a larger extent than subjects still on treatment or discontinuing the treatment prematurely. Improvement of asthma was twice as common among patients who completed compared to discontinued treatment (42 vs. 20%). Younger age (37 ± 12 vs. 41 ± 11 years, p < 0.001) and a higher prevalence of reported oral and/or gastrointestinal side effects (49 vs. 24%, p = 0.02) characterised the group that terminated SLIT. Forgetfulness was the most commonly reported specific reason.ConclusionTreatment perseverance resulted in improved patient reported outcome. Forgetfulness was the most frequently reported reason for discontinuing SLIT treatment against grass pollen allergy.

Highlights

  • Sublingual immunotherapy (SLIT) is effective, tolerable, and convenient for many allergic patients

  • Patients From 2006 to 2016 a total of 329 consecutive grass allergic patients started on Grazax (Phleum pratense 75.000 standardized quality-tablet (SQ-T)/2800 Bioequivalent Allergy Units (BAU), ALK, Denmark) at the Allergy Department at Uppsala University Hospital at Uppsala University Hospital, Sweden

  • They were confirmed to be allergic to timothy grass by skin pricktest or measurement of specific IgE and subsequently they were prescribed sublingual immunotherapy (SLIT) (Grazax)

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Summary

Introduction

Sublingual immunotherapy (SLIT) is effective, tolerable, and convenient for many allergic patients. Real-world evidence is scarce and the aim of this study is to assess the patient reported outcome of treatment with SLIT against grass pollen allergy in a consecutive patient population. Sublingual immunotherapy (SLIT) with ­Grazax® (ALK, Denmark) is well documented for the treatment of grass pollen allergy. The distinct effect comprises reduced symptom score in rhinoconjunctivitis, reduced medication score, an increased number of well days and a relevant improvement in quality of life [1,2,3,4,5,6]. Irrespective of the severity of symptoms, patients suffering from transitory symptoms from seasonal hay fever during the grass pollen season, may find once daily treatment for 3 years somewhat challenging. The explanations for poor subcutaneous immunotherapy adherence in this study included inconvenience, lack of efficacy, costs and loss of working

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