Conjunctival Provocation Test Research Articles

Current aspects of vernal and atopic keratoconjunctivitis

Vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are complex and rare diseases. Thus, their diagnosis and treatment are often achallenge. Discussion on the epidemiology, new pathogenetic concepts, interesting clinical findings, diagnostic possibilities and new treatment options and their side effects in severe ocular allergies. Analysis of the presentation of VKC in the internet. Evaluation of recent review articles, original publications, and case reports on the topics of VKC and AKC over the past 5years. Ocular allergies have significantly increased over the last decades. Recent concepts discussed in the pathogenesis of VKC and AKC are the role of the local and gut microbiome as well as the influence of neuroinflammation. Keratoconus is significantly more common in patients with VKC and AKC compared to the normal population. It is associated with faster progression and a more severe course of disease. Aconjunctival provocation test is only rarely necessary in the diagnosis of allergic conjunctivitis. Treatment of atopic dermatitis with dupilumab, an interleukin 4 receptor alpha (IL-4Ra) antagonist, can cause ocular side effects. Unfortunately, information available on the internet for patients and parents on the topic of VKC is sometimes dangerously incorrect. From the abovementioned new pathogenetic concepts, preventive and personalized treatment options could be developed in the future. Keratoconus in AKC/VKC must be recognized and treated early. Official guidelines are now available for astandardized conjunctival provocation test in the diagnosis of allergic conjunctivitis. The unwanted ocular side effects of dupilumab are often difficult to discriminate from the actual underlying AKC and respond well to anti-inflammatory treatment. Patients with VKC must be informed about the incorrect information on the internet regarding their disease.

A high-dose, depigmented polymerized birch pollen extract for subcutaneous allergen immunotherapy has a favourable efficacy/safety ratio.

Subcutaneous allergen immunotherapy (SCIT) with depigmented, polymerized (DPP) birch pollen extract has been marketed at doses of up to 1000 DPP units/mL since 2001. We sought to determine the dose-dependent efficacy of a DPP birch pollen extract formulation in patients suffering from birch-pollen-induced allergic rhinitis or rhinoconjunctivitis with or without intermittent asthma. A titrated conjunctival provocation test (CPT) was applied as a surrogate marker. This Phase II randomized, double-blind, parallel-group, dose-ranging clinical trial was performed at 39 centres in Germany, Lithuania and Poland. After randomization to four dose-level groups (100, 1000, 5000 and 10,000 DPP units/mL) and up-dosing, participants received maintenance SCIT with five monthly subcutaneous injections. The primary endpoint was the proportion of patients in whom a higher concentration of birch pollen (vs. baseline) was needed to elicit a positive CPT. Three hundred forty-three patients were included (mean (range) age: 42.6 (19-70)). The highest CPT responder rates were seen in the higher dose-level groups. In the intention-to-treat analysis, the difference between the 100 and 10,000 groups was statistically significant (p=0.0118). Although the proportion of patients with ≥1 treatment-emergent adverse events increased with the dose, almost all these events were mild (65.6%) or moderate (18.5%). Judging by the results of a CPT, the efficacy/safety ratio in SCIT appears to be favourable for a high-dose-level preparation of a DPP birch pollen extract.

Validation of AI-based software for objectification of conjunctival provocation test.

Provocation tests are widely used in allergology to objectively reveal patients' sensitivity to specific allergens. The objective quantification of an allergic reaction is a crucial characteristic of these tests. Because of the absence of objective quantitative measurements, the conjunctival provocation test (CPT) is a less frequently used method despite its sensitivity and simplicity. We developed a new artificial intelligence (AI)-based method, called AllergoEye, for quantitative evaluation of conjunctival allergic reactions and validated it in a clinical study. AllergoEye was implemented as a 2-component system. The first component is based on an Android smartphone camera for screening and imaging the patient's eye, and the second is personal computer-based for image analysis and quantification. For the validation of AllergoEye, an open-label, prospective, monocentric study was carried out on 41 patients. Standardized CPT was performed with sequential titration of grass allergens in 4 dilutions, with the reaction evaluated by subjective/qualitative symptom scores and by quantitative AllergoEye scores. AllergoEye demonstrated high sensitivity (98%) and specificity (90%) as compared with human estimation of allergic reaction. Tuning cutoff thresholds allowed us to increase the specificity of AllergoEye to 97%, at which point the correlation between detected sensitivity to allergen and specific IgE carrier-polymer system class becomes obvious. Strikingly, such correlation was not found with sensitivity to allergen detected on the basis of subjective and qualitative symptom scores. The clinical validation demonstrated that AllergoEye is a sensitive and efficient instrument for objective measurement of allergic reactions in CPT for clinical studies as well as for routine therapy control.

Clinic and diagnostics of house dust mite allergy

SummaryHouse dust mite allergens are common triggers for allergic rhinoconjunctivitis and allergic asthma; they can aggravate atopic dermatitis and rarely lead to anaphylactic reactions due to dust mite allergens in food. Typical symptoms are nasal obstruction, sneezing, and irritation, and more often than in pollen allergy, allergic asthma also develops. The symptomatology exists in principle throughout the year with maximum complaints in autumn and winter. Of particular importance are sleep disturbances due to nasal obstruction, which lead to restrictions in the quality of life and performance of affected patients. Sensitization can be proven by skin tests and detection of serum allergen-specific IgE antibodies; proof of allergy is achieved by nasal or conjunctival provocation tests. The diagnosis of local allergic rhinitis can only be made by provocation or by determination of allergen-specific IgE antibodies in nasal secretions. The quality of the allergen extract used is essential for all tests; it must contain the allergens to which a patient is sensitized. The concentration of Der p 23 in house dust mite extracts is particularly critical.

Prevalence of allergic sensitization with vernal keratoconjunctivitis: A systematic review with meta-analyses.

To determine the prevalence of allergic sensitization in patients with vernal keratoconjunctivitis (VKC) and to provide an overview of published studies on this topic. We systematically searched 11 literature databases on 24 May 2021, for studies with cross-sectional data on the prevalence of positive allergy tests in patients with VKC. Our main outcome of interest was the prevalence of allergic sensitization and the allergens involved. Prevalence meta-analyses were made to provide summary estimates. We identified 33 eligible studies for qualitative review with 2122 patients with VKC. Studies were predominantly based on patients seen in ophthalmology clinics. Overall, studies reported that the most prevalent positive allergen tests were the inhaled allergens house dust mites and pollen. Twenty-nine studies were eligible for the quantitative analysis. Here, we calculated the prevalence of allergen-positive patients to 57.7% (95% confidence interval: 52.5%-62.8%). Subgroup analyses of pooled estimates on sensitization based on specific testing methods found prevalence estimates of 51.4% for conjunctival provocation test, 68.7% for total tear IgE, 58.9% for specific tear IgE, and 58.2% for skin prick test. The prevalence of allergic sensitization in patients with VKC is 57.7%, and mostly towards inhaled allergens. The most frequent positive allergens are house dust mites and pollen. Identifying possible clinically relevant allergens provide information that may aid in managing VKC, such as environmental allergy-avoidance or allergy-specific treatment.

Baseline Conjunctival Provocation Testing Score Predicts Grass-Specific Immunoglobulin Response

A baseline conjunctival provocation test (CPT) score was optimized to predict which subjects with grass pollen induced seasonal allergic rhinitis/rhinoconjunctivitis would benefit most from treatment with a modified grass allergen subcutaneous immunotherapy (SCIT) product using MicroCrystalline Tyrosine and Monophosphoryl Lipid A as adjuvant system. A corresponding predictive treatment effect of the Immunoglobulin (Ig)G4 response would further strengthen these findings.

Type IV hypersensitivity to timolol

Type IV hypersensitivity to timolol

Conjunctival Provocation Test With Blomia tropicalis.

Background: Conjunctival provocation test (CPT) is used to demonstrate clinical relevance to a specific allergen. Blomia tropicalis (Bt) is a prevalent allergen in tropical regions. Its major allergen Blo t 5 is commonly detected in house dust in Brazil. Patients with allergic rhinoconjunctivitis (ARC) have IgE antibodies to Bt although it may not indicate clinical allergy.Objective: The purpose of this study is to demonstrate the role of CPT in clinical allergy to Bt in allergic conjunctivitis (AC).Methods: CPT was performed in asymptomatic subjects with ARC (n = 26) outside the grass pollen season. They had positive skin prick tests (SPT) to Bt and other common inhalant allergens and they were off topical or systemic antihistamines. Standardized allergens were used for CPT (Blo t 5 462.5 ng/mL in 1:1 solution, Alk Abelló). CPT was conducted on a control group of subjects (n = 29) without symptoms of ARC and with negative SPT. CPT was performed with progressive doses of allergen solutions in normal saline (1:32, 1:16, 1:8, 1:4, 1:2). CPT with the same allergen dose that elicited a positive reaction was repeated one week later. The protocol was approved by the local Ethics Board and signed informed consent was obtained from all participants.Results: There were 92% (24/26) of positive CPT in subjects sensitized to Bt. Significant association was found between SPT and CPT results with Bt (p < 0.0001). CPT had 92% sensitivity and 100% specificity when compared to SPT results. Positive reactions with the same dose or one immediately higher occurred in 21 out of 22 subjects who repeated TPC 1 week later. Mild transient nasal symptoms (21/24) were the major side effects of positive CPT followed by moderate periorbital edema which occurred in 41% (10/24). One controlled asthmatic BT-sensitized subject developed wheezing and dyspnea during a positive CPT with Bt that cleared with inhaled albuterol (400 mcg). There were no reactions whatsoever of CPT in non-allergic subjects.Conclusion: This study demonstrated that Bt may cause allergic conjunctivitis in our population. In addition, CPT is a safe and reproducible test if standardized allergens are used.

A study on toxicity, local irritative effect of and allergic response to a novel intranasal medication containing N-phenylacetyl-L-prolylglycine ethyl ester

Development of novel medications for delivery of active ingredients with systemic absorption and high bioavailability is an actual challenge for modern pharmaceutical and medical science. Nowadays, the number of diseases of the central nervous system is continuously growing. These conditions lead to impairment of mnestic and intellectual brain functions, to a decrease in mental alertness and memory in particular, which results in deterioration in the quality of life, sometimes in disability and patients’ partial or complete dependence on other people. The existing variety of nootropics does not fully respond to modern criteria of clinical science and practice due to insufficient effectiveness and neuroavailability. Recently, scientists have drawn attention to the potential of intranasal administration for delivery of active ingredients with systemic effect to human blood flow. Intranasal administration for delivery of active ingredients will enhance neuroavailability and, thus, a therapeutic effect of drugs. At the Departments of Medicines Technology, Pharmacology and Medical Formulation of ZSMU, a composition of the novel medication containing N-phenylacetyl-L-prolylglycine ethyl ester for intranasal delivery was developed as the result of complex physical and chemical, microbiological and biopharmaceutical experiments. The medication contains 1 % of N-phenylacetyl-L-prolylglycine ethyl ester, 5 % of Glycerin and Poltava Bischofite (standardized solution prepared at the Department of Medicines Technology of ZSMU), Sodium carboxymethyl cellulose solution and Tween 80 (1 %). Given the above, the urgent task is to study some safety parameters of the developed dosage form. The aim of the research is to study some toxicological parameters, local irritative effect of and allergic response to an effective dose of created medication containing N-phenylacetyl-L-prolylglycine ethyl ester for intranasal delivery. Materials and methods. The created medications for intranasal delivery were used as materials for each test. These medications contained N-phenylacetyl-L-prolylglycine ethyl ester (Noopept) 1 %, Glycerin and standardized Poltava Bischofite (5 % each), Sodium carboxymethyl cellulose solution, and Tween 80 (1 %). N-phenylacetyl-L-prolylglycine ethyl ester (CAS №157115-85-0, obtained from Shijiazhuang Prosperity Import and Export Co., Ltd., China. Purity: ≥98 %), Poltava Bischofite (standardized solution prepared at the Department of Medicines Technology of ZSMU), Polysorbate 80 (obtained from Limited liability company “Synbias”, Kyiv), Sodium carboxymethyl cellulose (obtained from Limited liability company “Synbias”, Kyiv), Glycerin (obtained from Limited liability company “Synbias”, Kyiv), Benzalkonium chloride (obtained from Limited liability company “Istok-Plus”, Zaporizhzhia). A study of acute toxicity, allergic response and irritating effect on skin, and cutaneous anaphylaxis reaction was conducted on white rats. Local irritative effect (Conjunctival allergen provocation test, CAPT) of created medication containing N-phenylacetyl-L-prolylglycine ethyl ester for intranasal delivery was determined on guinea pigs in accordance with recommendations of the State Pharmacological Center of the Ministry of Health of Ukraine and other recommendations. Results were statistically processed by means of the standard statistical package of the licensed program Statistica for Windows 13 (StatSoft Inc., № JPZ804I382130ARCN10-J). For all analysis types the P-value &lt;0.05 (95 %) was considered statistically significant. Results. One-time intranasal delivery of the maximum allowable volume of the medication under research (0.4 ml) to the rats weighing 100 g in a dose of 40 mg/kg did not result in death of any of 6 animals of the experimental group overnight. In the course of studying potential local irritative effect of the intranasal gel containing N-phenylacetyl-L-prolylglycine ethyl ester, two experimental animals out of 10 developed a slight reddening of the conjunctiva immediately after the administration. No changes in mucous membrane of the eyes were observed in other eight experimental animals. Daily application of the studied medication for intranasal delivery (0.5 g) to a shaved area of the lateral surface of the animals’ bodies (4 × 4 cm) during 5 days, and consequent one-time application of the intranasal gel containing N-phenylacetyl-L-prolylglycine ethyl ester (0.3 g), did not result in anaphylactic shock development. No visible reactions were detected in the experimental animals after 20 more skin applications of the intranasal gel containing N-phenylacetyl-L-prolylglycine ethyl ester during 4 weeks (5 times per week). The skin area exposed to application in animals of the control and experimental groups looked the same. Conclusions. Complex studies of some toxicological parameters (such as mortality, dynamics of body weight change, local irritative effect and allergic response to the effective dose of a novel medication containing N-phenylacetyl-L-prolylglycine ethyl ester for intranasal delivery) have been performed. Summarizing obtained results, it can be confirmed that the medication under study does not cause any local irritative effect and allergic response and does not demonstrate general toxic effects in case of its intranasal delivery. Thus, further research of the novel medication containing N-phenylacetyl-L-prolylglycine ethyl ester for intranasal administration has a potential perspective.

The conjunctival allergen provocation test and the nasal allergen provocation test as specific alternatives to the oral food challenge.

Provocation tests with allergens play a critical role in differential diagnosis of allergic diseases. The nasal allergen provocation test and the conjunctival allergen provocation test are particularly useful in the diagnosis of allergies with the underlying mechanism involving IgE-dependent reactions. Interestingly, the symptoms typical of both the nasal allergen provocation test and conjunctival allergen provocation test occur during the tests: ocular symptoms during the nasal test and typical nasal symptoms during the conjunctival test. These symptoms provide a picture of the early and late phases of the allergic reaction. Increasing attention is given to the role of the two provocation tests in differential diagnosis of food allergies, and the first studies involving food challenge tests provide a solid foundation for further research in this area.

Intradermal Phleum pratense allergoid immunotherapy. Double-blind, randomized, placebo-controlled trial.

BackgroundIn allergology, the intradermal approach is generally used to establish an aetiological diagnosis, with limited experience in specific allergen immunotherapy.ObjectiveTo evaluate the efficacy and safety of immunotherapy with an allergen extract of glutaraldehyde‐polymerized Phleum pratense, administered intradermally, in patients with rhinoconjunctivitis sensitized to grass pollen.MethodsMulticentre, randomized, double‐blind, placebo‐controlled clinical trial in patients from 12 to 65 years of age with rhinitis or rhinoconjunctivitis, with or without asthma, due to grass pollen allergy. Patients were divided into three groups and received a total of six doses in a weekly interval, of either placebo; 0.03 or 0.06 μg of protein per dose of P pratense allergoid. The primary objective was to evaluate the combined symptoms and medication consumption score (CSMS). The secondary objectives were symptoms and medication, tolerance to the conjunctival provocation test, specific IgE and IgG4 antibodies and the safety profile according to the WAO scale.ResultsThe dose of 0.06 μg of protein proved to be effective versus the placebo by significantly reducing CSMS and increasing tolerance to the allergenic extract in the conjunctival provocation test, after the first pollen season. This group showed a significant reduction in specific IgE after the second pollen season relative to the baseline. There were no variations in IgG4 levels. Only one grade 2 systemic reaction was recorded.Conclusion & Clinical RelevanceIntradermal immunotherapy with P pratense allergoid has been shown to be effective and safe, reducing CSMS, increasing tolerance to the conjunctival provocation test and reducing IgE levels.

Profilin is a marker of severity in allergic respiratory diseases.

The capacity of profilin to induce allergic symptoms in patients with respiratory allergy has been questioned. In this sense, the aim of this study was to investigate the correlation between profilin exposure and induction of symptoms in a prospective case-control study. The concentration of profilin as well as pollen levels in the air was measured. A diary score of symptoms was collected from allergic patients. Seventy-nine individuals were included in the study; fifty cases and 28 controls were positive or negative to profilin, respectively. Conjunctival and bronchial provocation tests were performed with purified profilin (Pho d 2) in a subgroup of cases and controls. Profilin was detected in the environment on 133days (maximum peak of 0.56ng/m3 ). A positive correlation between profilin and pollen count of Olea and Poaceae was observed (ρ=0.24; P<.001). Intensity of total, nasal and ocular symptoms was statistically higher in cases than in controls (P<.001). The risk of suffering symptoms, measured by the percentage of patients who presented any of the symptoms each day, was also higher in cases than in controls. The provocation test was positive in 95% of bronchial and 90% of conjunctival challenges in cases, and negative in all controls. Profilin was detected in the environment and had the ability to induce a specific allergen response. Patients sensitized to this panallergen showed more symptoms and were more likely to have symptoms. Therefore, sensitization to profilin seems to be a marker of severity in patients with rhinoconjunctivitis and asthma mediated by pollen.

Children Monosensitized to Can f 5 Show Different Reactions to Male and Female Dog Allergen Extract Provocation: A Randomized Controlled Trial

Dog dander consists of several allergenic molecules including Can f 5, which is a protein expressed in the prostate of male dogs. To investigate whether children monosensitized to Can f 5 show different reactions to provocation tests with male versus female dog dander in a double-blind randomized clinical trial. Twenty-two children (15-18 years) with a history of dog sensitization were enrolled from the COpenhagen Prospective Studies on Asthma in Childhood2000 mother-child cohort. Skin prick test, specific IgE levels to dog dander (e5), and dog components Can f 1, 2, 3, and 5 were first assessed. We subsequently performed skin prick test and conjunctival allergen provocation test using dog dander collected separately from male and female dogs. Seven of the 22 children were monosensitized to Can f 5. Eight were sensitized to a mix of the dog components, and 7 were no longer sensitized to dog. Of the children monosensitized to Can f 5, all had a positive skin prick test result to male dog extract and 1 of 7 was also positive to female dog extract (P= .01). Furthermore, 5 of 7 had a positive conjunctival allergen provocation test result to male dog extract and 1 of 7 also reacted to the female dog extract (P= .03). There was no difference between reactions to male and female dog extract provocation in children sensitized to a mix of the dog components. Children monosensitized to Can f 5 show different reactions to male and female dog extract provocation using both skin prick test and conjunctival allergen provocation test, suggesting tolerance to female dogs.

P103 USE OF THE CONJUNCTIVAL PROVOCATION TEST AS PRIMARY ENDPOINT FOR PHASE II DOSE RESPONSE STUDIES

Conjunctival Provocation testing is a simple, standardized and reliable means of assessing the efficacy of immunotherapy. Three phase II dose range finding studies were performed using modified allergen tyrosine adsorbate (MATA) and monophosphoryl lipid A (MPL) adjuvants for the treatment of allergic rhinoconjunctivitis (ARC) in patients with pollen allergy, using the total symptom score (TSS) of the conjunctival provocation test (CPT) as primary endpoint.

Strong dose response after immunotherapy with PQ grass using conjunctival provocation testing

BackgroundPollinex Quattro Grass (PQ Grass) is an effective, well-tolerated, short pre-seasonal subcutaneous immunotherapy to treat seasonal allergic rhinoconjunctivitis (SAR) due to grass pollen. In this Phase II study, 4 cumulative doses of PQ Grass and placebo were evaluated to determine its optimal cumulative dose. MethodsPatients with grass pollen-induced SAR were randomised to either a cumulative dose of PQ Grass (5100, 14400, 27600 and 35600 SU) or placebo, administered as 6 weekly subcutaneous injections over 31–41 days (EudraCT number 2017-000333-31). Standardized conjunctival provocation tests (CPT) using grass pollen allergen extract were performed at screening, baseline and post-treatment to determine the total symptom score (TSS) assessed approximately 4 weeks after dosing. Three models were pre-defined (Emax, logistic, and linear in log-dose model) to evaluate a dose response relationship. ResultsIn total, 95.5% of the 447 randomized patients received all 6 injections. A highly statistically significant (p < 0.0001), monotonic dose response was observed for all three pre-specified models. All treatment groups showed a statistically significant decrease from baseline in TSS compared to placebo, with the largest decrease observed after 27600 SU (p < 0.0001). The full course of 6 injections was completed by 95.5% of patients. Treatment-emergent adverse events were similar across PQ Grass groups, and mostly mild and transient in nature. ConclusionsPQ Grass demonstrated a strong curvilinear dose response in TSS following CPT without compromising its safety profile.

Neurotrophic factors and nerve growth factor in ocular allergy.

During allergic reaction, nervous and immune systems mutually interact through release of mediators, including neurotrophic factors and nerve growth factor (NGF). These mediators modulate allergic reaction through binding their receptors expressed by immune and structural cells and by stimulating neuropeptide release by nerves. The role of neuropeptides and NGF has been demonstrated in allergic asthma and rhinitis, and, to a lesser extent, in allergic conjunctivitis. The aim of this review are to elucidate the evidence of the role of NGF and neuropeptides in the pathogenesis of allergic conjunctivitis. NGF modulates allergic reaction by stimulating release of cytokines, inflammatory mediators and neuropeptides by immune and structural cells and nerve endings at the site of inflammation. Evidence showed that local and systemic NGF levels increase in patients with allergic conjunctivitis, including allergic rhinoconjuncivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. We recently described an increase of conjunctival p75NTR expression in patients with allergic rhinoconjuncivitis, and an increase of tear levels of NGF after conjunctival provocation test with allergen. NGF modulates ocular allergic reaction. Increasing understanding of the role of neuropeptides in allergic conjunctivitis may pave the way to the development of novel therapeutic approaches and improvement of patients' management.

Diagnosing and managing allergic conjunctivitis in childhood: The allergist's perspective.

Allergic conjunctivitis in childhood often poses problems of diagnosis and management for the allergist. We present the salient points concerning the diagnosis and treatment of ocular allergy emerging from a large cohort survey conducted jointly in the departments of ophthalmology and paediatric allergy in a French teaching hospital. Seasonal acute conjunctivitis is a common disorder and not overly difficult to diagnose and treat when associated with rhinitis leading to allergic rhinoconjunctivitis. An ophthalmologist should be consulted when conjunctivitis occurs alone and if another form of conjunctivitis is suspected, such as perennial allergic conjunctivitis, vernal keratoconjunctivitis or atopic keratoconjunctivitis. When IgE-mediated hypersensitivity assessment does not establish aetiological diagnosis, a conjunctival allergen provocation test can be performed. The principal non-IgE-mediated allergy is chronic blepharoconjunctivitis. The main problem for differential diagnosis is the presence of signs suggestive of dry eye. Management includes non-pharmacological treatments, such as lacrimal substitutes, avoidance measures and protection of the ocular surface. Second-line treatment consists of eye drops, preferably single dose or without additives and with dual local action, mast cell stabilizer action and antihistaminic action. Third-line treatment is reserved for severe forms. Short-lasting local steroid therapy can control flare-ups of allergic keratoconjunctivitis, which should have specialized follow-up. Cyclosporine is a disease-modifying treatment, which is both effective and well tolerated.

Liposomal Eye Spray Is as Effective as Antihistamine Eye Drops in Patients with Allergic Rhinoconjunctivitis Induced by Conjunctival Provocation Testing

Background: Liposomal eye spray (LS) has been introduced for the treatment of dry eye. Whether LS can also relieve symptoms due to allergic rhinoconjunctivitis (ARC) has not yet been sufficiently investigated. Objectives: The aim of this study was to assess the onset of action, the reduction of allergy symptoms, and the safety of LS – a nonpharmacological treatment option – compared with those of antihistamine eye drops (AD). Methods: In this open, prospective, controlled, monocenter noninterventional study, adults with ARC received either LS or AD for the relief of eye irritation after a positive conjunctival provocation test (CPT). All patients completed a questionnaire before and after the CPT. Eye irritation was rated on a visual analogue scale (VAS) at 6 time points. Conjunctival redness was analyzed using objective digital analysis based on images taken during the study visit. Results: Data were collected from 40 patients (20 per group). In both groups, 80% of patients perceived an onset of action within 0–2 min after application of LS or AD following the CPT. Relief of eye irritation (as determined by VAS) increased throughout the visit for both groups. In the digital analysis, the mean proportion of redness of the eye decreased from 10.3 to 7.0% for LS and from 10.4 to 6.5% for AD, with the largest difference observed 10 min after application (LS: 8.9%; AD: 6.0%; p = 0.094). Conclusions: LS is a nonpharmacological treatment option for ARC, showing no significant difference or relevant numerical inferiority to AD in any parameter studied. It was generally safe and well tolerated.

Non-pharmacological treatment with Liposomal Eye Spray Is As Effective As Antihistamine Eye Drops For The Relief Of Allergic Rhinoconjunctivitis Symptoms Induced By Conjunctival Provocation Testing

Non-pharmacological treatment with Liposomal Eye Spray Is As Effective As Antihistamine Eye Drops For The Relief Of Allergic Rhinoconjunctivitis Symptoms Induced By Conjunctival Provocation Testing

Strong Dose-response Using a Conjunctival Provocation Test During a Phase II Allergen Immunotherapy Study With Subcutaneously Administered Tyrosine Adsorbed Modified Grass Allergen + MPL

Strong Dose-response Using a Conjunctival Provocation Test During a Phase II Allergen Immunotherapy Study With Subcutaneously Administered Tyrosine Adsorbed Modified Grass Allergen + MPL