Study Of Sublingual Immunotherapy Research Articles

Practical Study of Sublingual Immunotherapy in Patients with Japanese Cedar Pollinosis Using a Questionnaire Comparison Among the First Season, Second Season and Third Season

Practical Study of Sublingual Immunotherapy in Patients with Japanese Cedar Pollinosis Using a Questionnaire Comparison Among the First Season, Second Season and Third Season

The Relationship of Pollen Dispersal with Allergy Symptoms and Immunotherapy: Allergen Immunotherapy Improves Symptoms in the Late Period of Japanese Cedar Pollen Dispersal

Background: The severity of symptoms of pollen-induced allergic rhinitis is affected by the amount of scattered pollen. However, the relationships between the pollen dispersal pattern, symptom severity, and treatment efficacy are not clear. Methods: Between 2007 and 2012, we performed 4 randomized, placebo-controlled studies of sublingual immunotherapy (SLIT) on patients with Japanese cedar-induced allergic rhinitis who lived in or around Chiba, Japan. The participants were asked to avoid using rescue medicines during the cedar pollen season as much as possible and to record their nasal symptoms in allergy diaries. The amount of pollen dispersed daily was quantified using the Durham method, and the season was divided into early and late periods based on the pollen count. Results: A total of 721 patients were enrolled in the 4 studies during the 6-year study period. In the placebo group (n = 349), a correlation was observed between the amount of pollen dispersed and the severity of symptoms in the early but not late period of pollen dispersal. Treatment with SLIT (n = 372) significantly improved symptom severity in the late but not early period. Conclusion: For patients with Japanese cedar pollen-induced allergic rhinitis, the fluctuation of daily pollen dispersal had a minimal effect on the severity of symptoms during the late period. SLIT was remarkably effective in alleviating symptoms during this period but not in the early period.

アンケートを用いた舌下免疫療法に関するスギ花粉症患者の実態調査 1シーズン目と2シーズン目の比較

アンケートを用いた舌下免疫療法に関するスギ花粉症患者の実態調査 1シーズン目と2シーズン目の比較

PD14 ‐ Non‐interventional 2‐year study of sublingual immunotherapy in children and adolescents with allergic rhinoconjunctivitis caused by grass pollen

Background The aim of this non-interventional study was to document the impact of a sublingual allergen immunotherapy (AIT) with Oralair 5-grass pollen tablets (Stallergenes, France) on symptom severity, use of symptomatic medication and tolerability in patients with grass pollen-induced allergic rhinoconjunctivitis (RC) over 2 years of routine medical practice treatment. This poster focuses on the subgroups of children (4-11 yrs) and adolescents (12-17 yrs).

Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and Asthma

Allergic rhinitis affects up to 40% of the US population. To desensitize allergic individuals, subcutaneous injection immunotherapy or sublingual immunotherapy may be administered. In the United States, sublingual immunotherapy is not approved by the Food and Drug Administration. However, some US physicians use aqueous allergens, off-label, for sublingual desensitization. To systematically review the effectiveness and safety of aqueous sublingual immunotherapy for allergic rhinoconjunctivitis and asthma. The databases of MEDLINE, EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials were searched through December 22, 2012. English-language randomized controlled trials were included if they compared sublingual immunotherapy with placebo, pharmacotherapy, or other sublingual immunotherapy regimens and reported clinical outcomes. Studies of sublingual immunotherapy that are unavailable in the United States and for which a related immunotherapy is unavailable in the United States were excluded. Paired reviewers selected articles and extracted the data. The strength of the evidence for each comparison and outcome was graded based on the risk of bias (scored on allocation, concealment of intervention, incomplete data, sponsor company involvement, and other bias), consistency, magnitude of effect, and the directness of the evidence. Sixty-three studies with 5131 participants met the inclusion criteria. Participants' ages ranged from 4 to 74 years. Twenty studies (n = 1814 patients) enrolled only children. The risk of bias was medium in 43 studies (68%). Strong evidence supports that sublingual immunotherapy improves asthma symptoms, with 8 of 13 studies reporting greater than 40% improvement vs the comparator. Moderate evidence supports that sublingual immunotherapy use decreases rhinitis or rhinoconjunctivitis symptoms, with 9 of 36 studies demonstrating greater than 40% improvement vs the comparator. Medication use for asthma and allergies decreased by more than 40% in 16 of 41 studies of sublingual immunotherapy with moderate grade evidence. Moderate evidence supports that sublingual immunotherapy improves conjunctivitis symptoms (13 studies), combined symptom and medication scores (20 studies), and disease-specific quality of life (8 studies). Local reactions were frequent, but anaphylaxis was not reported. The overall evidence provides a moderate grade level of evidence to support the effectiveness of sublingual immunotherapy for the treatment of allergic rhinitis and asthma, but high-quality studies are still needed to answer questions regarding optimal dosing strategies. There were limitations in the standardization of adverse events reporting, but no life-threatening adverse events were noted in this review.

Comment on "therapeutic effects and biomarkers in sublingual immunotherapy: a review".

Numerous sublingual immunotherapy studies have shown efficacy using a wide variety of dosing regimens. Despite a few grade III and one anaphylactic reaction due to a patient over-dose, there have been no fatal reactions resulting from sublingual immunotherapy treatment. Although safer than SCIT, SLIT is still immunotherapy. Special consideration should be given to what will ensure the highest level of safety for the patient given his or her history, exam and allergy test results. Dosing levels for sublingual immunotherapy should be based on what is therapeutically effective for each individual patient and adjusted accordingly throughout the treatment course.

Recommendations for appropriate sublingual immunotherapy clinical trials

Sublingual immunotherapy is gaining widespread attention as a viable alternative to subcutaneous immunotherapy for the treatment of allergic rhinoconjunctivitis. In addition, sublingual immunotherapy has been studied in other allergic disorders including asthma. However, a review of published studies indicates that there are deficiencies and considerable heterogeneity in both design and data interpretation of sublingual immunotherapy studies. These deficiencies have made it somewhat difficult to assess the appropriate place of sublingual immunotherapy in guidelines for the therapy of allergic diseases. Moreover, several unpublished oral and sublingual immunotherapy studies in the United States failed to meet primary endpoints. This article reviews data from sublingual immunotherapy trials and makes recommendations about appropriate designs of future sublingual immunotherapy studies. It is hoped that these recommendations will result in more adequately designed sublingual immunotherapy trials to facilitate the appropriate placement of this therapy to treat patients with allergic rhinoconjunctivitis and other allergic diseases.

Double-blind, placebo-controlled study of sublingual immunotherapy in patients with latex-induced urticaria: a 12-month study

Natural rubber latex (NRL) allergy is a worldwide problem. Although prevention is sufficient to reduce sensitization, prolonged avoidance is needed to prevent resensitization or adverse reactions on re-exposure. This double-blind, placebo-controlled study was conducted to determine the efficacy of sublingual immunotherapy (SLIT) with latex. Forty patients with NRL allergy were enrolled. At diagnosis, 30 presented urticaria and 10 asthma. Patients were evaluated on their clinical history and an allergological assessment: skin prick test with latex extract, serum-specific IgE and provocation tests. Patients were subdivided by complaint (asthma or urticaria), and randomized to receive SLIT with latex extract (ALK-Abelló, Lainate, Milan, Italy) or placebo. The evaluable population consisted of 35 patients, 18 treated with SLIT and 17 with placebo. The results show that 12 months of SLIT improved the symptoms score and reduced the medication score in all subjects. The subjective evaluation was corroborated by improved bronchial and glove provocation test results. The latex-specific IgE levels increased slightly in the SLIT group, and skin sensitization was reduced at the end of the trial in all the patients treated with SLIT. The immunotherapy was not complicated by any severe adverse reactions. This is the first double-blind, placebo-controlled evaluation of the efficacy of SLIT with latex extract conducted in adult patients allergic to NRL. SLIT with latex can be proposed for subjects with latex allergy, especially those for whom complete avoidance of latex exposure may be very difficult or even impossible. More studies are needed to evaluate the efficacy of SLIT in the treatment of subjects with latex allergy who are sensitized to inhalant allergens.

Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children

Subcutaneous immunotherapy has been the principal approach of immunotherapy in the treatment of allergic diseases. Several clinical studies with birch, alder or hazel pollen extract conducted as subcutaneous immunotherapy have been published suggesting a well-tolerated and clinically effective treatment. Only a few clinical studies of sublingual immunotherapy (SLIT) with these allergens have been published. This study investigated the clinical efficacy, safety and dose-response relationship of SLIT in children suffering from rhinoconjunctivitis with/without asthma. Eighty-eight children (5-15 years) with a history of tree pollen-induced allergic rhinoconjunctivitis with/without seasonal asthma for >or=2 years were included. Allergy to tree pollen was confirmed by positive skin-prick test, positive specific IgE and positive conjunctival provocation test. The extract used was a glycerinated mixture of Betula verrucosa, Corylus avellana and Alnus glutinosa 100,000 SQ-U/ml. Children were randomized into three groups receiving SLIT 5 days a week for up to 18 months; dose group 1: accumulated weekly dose of 24,000 SQ-U; dose group 2: accumulated weekly dose of 200,000 SQ-U; and placebo. In the birch pollen season, dose group 2 showed a significant reduction of symptom (P = 0.01) and medication scores (P = 0.04) compared with placebo. Dose group 1 showed a significant reduction of symptom scores (P = 0.03). There were no statistical differences between dose groups 1 and 2. All children tolerated the treatment well. SLIT with tree pollen extract provided dose-dependent benefits in tree pollen-allergic children in terms of significantly reduced symptoms and medication use. The treatment was well tolerated.

Longitudinal Study of Sublingual Immunotherapy with SQ Standardized Grass Allergen Tablet - Interim Safety Results

Longitudinal Study of Sublingual Immunotherapy with SQ Standardized Grass Allergen Tablet - Interim Safety Results

Randomized Controlled Open Study of Sublingual Immunotherapy for Respiratory Allergy in Real-Life: Clinical Efficacy and More

Randomized Controlled Open Study of Sublingual Immunotherapy for Respiratory Allergy in Real-Life: Clinical Efficacy and More