Sublingual Specific Immunotherapy Research Articles

Poster 1000: Efficacy and safety of specific sublingual immunotherapy with carbamylated allergoid tablets of ragweed pollen: a dose-ranging study

Methods A prospective multicenter double-blind randomized dose-ranging study (EudraCT number 2011-004522-10) was conducted following GCP rules in patients with history of ragweed-related moderate-to-severe allergic rhinoconjunctivitis for at least 2 years, with or without controlled seasonal allergic asthma, and positive response to allergen specific nasal provocation test (NPT). Before the 2013 ragweed pollen season adult patients were assigned to different daily dosages (3001000-2000 UA) of tablets of ragweed pollen carbamylated extract given for 4 months. The primary end-point was the individual change in the response to NPT before and after the treatment (allergic symptoms and threshold provocative dose to identify improved, unchanged, worsened subjects). Secondary end-points included the analysis of this improvement considering the severity level (depending on symptoms score and provocative dose), the change of nasal peak inspiratory flow (NPIF) in response to NPT, and the incidence of adverse events. Results Seventy-three subjects were enrolled and 52 were randomized (1:1:1) and treated. The proportion of improved patients was 77%, 88% and 81% in the 300 UA, 1000UA and 2000 UA groups respectively. A progressive trend to increased efficacy with flattening of the slope (mean severity level improvement: +1.38, +1.71 and +1.90 respectively) and a statistically significant difference between 300 UA and 2000 UA (p = 0.0187) were found. NPIF improved in all groups at the end of the study without significant differences among treatments (p = 0.41). One probable treatment-related AE occurred in group 1, 3 probable and 1 certain (mild) in group 2, 3 possible and 1 certain (moderate) in group 3. No serious treatment-related AEs occurred.

Specific immunotherapy in the treatment of atopic dermatitis: a systematic review using the GRADE system

BackgroundControversy exists regarding the potential role of specific immunotherapy (SIT) as a therapeutic intervention for patients with atopic dermatitis (AD) and aeroallergen sensitivity. ObjectiveTo critically appraise the evidence supporting the use of SIT for patients with AD and aeroallergen sensitivity. MethodsA literature search was performed using the terms immunotherapy plus atopic dermatitis and immunotherapy plus eczema. The same terms were used to search PubMed, Ovid, and Scopus. The limits were humans, English, and randomized controlled trial. Articles that were not in English or were observational in nature were excluded. These double-blinded randomized controlled trials were analyzed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. ResultsSeven articles fulfilled the inclusion characteristics; 1 involved sublingual SIT. All studies reported improvement in clinical symptoms of AD; however, studies differed in which type of patient (ie, with mild vs severe AD) benefited most from immunotherapy. Serious methodologic shortcomings were noted, including, but not limited to, many enrolled patients not completing participation; small study; and incomplete descriptions of randomization, blinding, allocation concealment, and/or data analysis not by intention to treat. ConclusionIn a systematic review using the GRADE system, the strength of recommendation is weak for use of SIT in patients with AD. High-quality evidence from methodologically sound double-blinded randomized controlled trials is needed to support administration of SIT for patients with AD.

Allergen-specific immunotherapy in patients 55 years and older: results and review of literature.

Introduction Over the years the immune system suffers many morphologic and functional alterations, which result in a peak of function in puberty and a gradual decrease in the elderly. Aim Treat patients 55 years or older with allergic rhinitis with immunotherapy and then analyze the response to allergens. Materials and Methods From June 2009 to July 2010, 104 charts of patients 55 years or older with allergic complaints were evaluated. The patients were selected by anamnesis, physical examination, and otorhinolaryngologic exam. The patients had cutaneous test for mites before and after 1 year of sublingual specific immunotherapy. The cutaneous response was classified as negative (absent), light, moderate, or severe. Results Before vaccination, 42 (40.4%) patients were classified as having a severe form of allergy and 62 (59.6%) as having a moderate allergy. After the specific therapy, 40 (38.4%) patients were classified as negative (absent), 37 (35.6%) as light, 19 (18.3%) as moderate, and 8 (7.7%) as severe responses. Conclusion Immunotherapy, a desensitization technique, is indicated in cases which patients cannot avoid the exposure to allergens and in situations where pharmacologic therapy is not ideal. Specific immunotherapy to treat the allergic rhinitis in elderly patients was efficient and had no collateral effects, and in addition to the clinical benefit, improvement in the cutaneous test could also be observed.

Grading local side effects of sublingual immunotherapy for respiratory allergy: Speaking the same language

Sublingual immunotherapy (SLIT) is increasingly used worldwide. Despite its safety being well ascertained, there is no universally accepted system to grade and classify its adverse events (AEs). According to the literature, it seems reasonable to classify and grade systemic side effects by using the previously published World Allergy Organization recommendations. On the other hand, local side effects are the most frequent with SLIT, sometimes leading to its discontinuation. Therefore grading of the severity of local side effects was perceived as necessary for the purpose of uniform reporting, classification, and quantification of this aspect. AWorld Allergy Organization Taskforce, after examining the available literature and the postmarketing surveillance data, proposed a clinically based grading of the severity of local AEs caused by SLIT. The use of the Medical Dictionary for Regulatory Activities nomenclature for AEs was also included in this context. The proposed grading system for SLIT-induced local reactions is expected to improve and harmonize surveillance and reporting of the safety of SLIT.

House dust mite sublingual immunotherapy: a double‐blind, placebo‐controlled study in elderly patients with allergic rhinitis

Immunotherapy in elderly patients is controversial, and there is still no evidence supporting this treatment's safety and efficacy in this population. This study was performed to evaluate the safety and efficacy of specific sublingual immunotherapy for house dust mite (HDM) allergens in patients over 60years of age with allergic rhinitis and a confirmed allergy to HDM. This study sought to assess nasal symptoms during HDM season, reduce medication use and monitor for adverse reactions during immunotherapy. One hundred and eleven 60- to 75-year-old patients with allergic rhinitis and a confirmed Dermatophagoides pteronyssinus and Dermatophagoides farinae allergy were included in the study. The patients were individually randomized to active or placebo groups using a double-blind method (NCTO01605760 ClinicalTrials.gov). A total of 51 subjects in the sublingual allergen-specific immunotherapy (SLIT) group (Staloral 300R, Stallergenes, France) and 57 subjects in the placebo group were monitored for 3years. Forty-seven patients completed 3years of SLIT, and 48 subjects finished the placebo treatment in the same time period. The total nasal symptom score decreased by 44% in the active group and 6% in the placebo group after 3years of SLIT. This difference was only significant in the active group (P<0.05). At the end of therapy, the total medication score of the active group decreased significantly by a maximum of 51% (P<0.05), whereas the total medication score of the placebo control group showed an insignificant decrease (P=0.56). There were no systemic adverse reactions during the study. Sublingual allergen-specific immunotherapy in elderly patients with a HDM allergy to D.pteronyssinus and D.farinae generated a significant clinical improvement in the active group compared with the placebo group, particularly during the heating season. This therapy was well tolerated.

Allergen specific sublingual immunotherapy (ASSIT) reduces Il-4 and enhances interferon-gamma intracellular expression by Cd8+ T-cells in perenneal allergic rhinitis (Par)

Subjects and methods Twenty adult PAR patients sensitive only to the mite D. farinae as diagnosed by Prick skin testing (PST) [Omega labs, Montreal, Canada] were included in the study. ASSIT to D. farinae was administered for 6 months. Flow cytometric evaluation of the intracellular expression of IL-4 and IFNgamma by CD3+ CD8+ T-cells was determined according to Manufacturer instructions (Beckton Dickenson) before and after ASSIT. The total 5 symptom score (T5SS) of PAR and the diameter of PST were also examined.

Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: Looking at the published evidence

In allergen immunotherapy there is debate as to whether polysensitized patients are best treated with many allergens simultaneously (chosen according to the sensitization profile, a predominantly North American approach) or a single allergen (chosen according to the most clinically problematic allergy, a predominantly European approach). In patients seeking treatment for moderate-to-severe respiratory allergies, polysensitization is more prevalent (range, 50% to 80%) than monosensitization in both the United States and Europe. Safe, effective, single-allergen preparations will most likely have been tested in polysensitized patients. In robust, large-scale clinical trials of grass pollen sublingual tablets, polysensitized patients benefited at least as much from allergen immunotherapy as monosensitized patients. A recent review of multiallergen immunotherapy concluded that simultaneous delivery of multiple unrelated allergens can be clinically effective but that there was a need for additional investigation of therapy with more than 2 allergen extracts (particularly in sublingual allergen immunotherapy). More work is also required to determine whether single-allergen and multiallergen immunotherapy protocols elicit distinct immune responses in monosensitized and polysensitized patients. Sublingual and subcutaneous multiallergen immunotherapy in polysensitized patients requires more supporting data to validate its efficacy in practice.

Immunothérapie spécifique sublinguale : ODISSEE un an après. Résultats préliminaires d’ODISSEE (Observatoire de l’indication, du choix de prise en charge par Immunothérapie spécifique sublinguale ainsi que de l’adhésion et de l’observance au traitement chez les patients souffrant d’allergie respiratoire – rhinite et/ou conjonctivite et/ou asthme allergique)

Aim of the survey To identify in current practice factors determining compliance and observance to sublingual specific immunotherapy (SLIT) in patients suffering respiratory allergy. Patients and methods French, multicentric, longitudinal survey, conducted from September 2009 to March 2011, in patients older than 5 years, allergic to house dust mite or pollens, and who had a SLIT initiated. Preliminary descriptive results after 1 year SLIT. Results The cohort included 1876 patients aged 23.8 ± 14.9 years; 49% were male. Predominant allergy was house dust mite (66.6%) and house dust mite plus pollens (36.6%). Compliance was excellent in 73.6% cases and medium in 16.8%. Adults, women or patients suffering rhinitis showed the best compliance. Observance as assessed by the patient was strong in 71.6% cases and moderate in 26.6%. After 1 year of treatment, 87.7% patients wished to continue SLIT, mainly because of symptomatic enhancement, seen in 72.6% of asthmatic and 87.6% of rhinitis patients, of the decrease in symptomatic treatment intake, seen in 73.6% of the patients, and of the better quality of life, seen in 59.1% of the patients. Tolerance was good, as expected with SLIT treatment. Conclusion L’Observatoire de l’indication, du choix de prise en charge par Immunothérapie spécifique sublinguale ainsi que de l’adhésion et de l’observance au traitement chez les patients souffrant d’allergie respiratoire (ODISSEE) showed that patients treated with SLIT are compliant and observant to the treatment, mainly owing to their acceptance and understanding of their disease.

Both sublingual and supralingual routes of administration are effective in long-term allergen-specific immunotherapy

The aim of this study was to confirm or refute the difference between efficacy of long-term specific immunotherapy (SIT) with standardized allergen vaccine consisting of six grass pollens (oat grass, orchard grass, fescue, rye grass, timothy grass, and rye) administered either by sublingual or by supralingual route. To investigate clinical and immunologic changes, 51 patients of a previous 1-year double-blind, placebo-controlled, randomized study were enrolled in an open randomized study that continued over the next 3 years. Sublingual or supralingual immunotherapy (SLIT) was performed in the same way, keeping the drops under or on the tongue, respectively, for 1-2 minutes before swallowing them. Data about symptoms scores and rescue medication intake during grass pollen seasons, as well as skin-prick test results, levels of specific IgG, and IgE antibodies were collected after each pollen season. It was clearly shown that both routes of administration were effective, leading to a significant decrease of clinical symptoms of grass pollen allergy after SIT lasting 3-4 years. No statistically significant difference between sublingually and supralingually treated patients was observed at the end of the study. Adverse effects were limited to a small number of generally mild local and/or systemic reactions with no significant difference between both administration ways of SIT. The significant therapeutic effect of both SLIT and supralingual immunotherapy lasting 3-4 years was clearly achieved. Despite no significant difference between efficacy of both administration ways of SIT, the onset of sublingual SIT effect seems to be slightly faster than that of supralingual SIT.

Efficacy of sublingual specific immunotherapy in patients with respiratory allergy to Alternaria alternata: a randomised, assessor-blinded, patient-reported outcome, controlled 3-year trial

Background:Alternaria alternata (AA) sensitisation is a common cause of respiratory allergies such as rhinitis and asthma. So far there are no controlled double-blind trials evaluating the efficacy and safety of specific sublingual immunotherapy (SLIT) in AA allergies.Objective:To evaluate the efficacy of SLIT treatment in terms of clinical improvement and rescue medication usage in patients with confirmed AA respiratory allergy.Subjects and methods:A randomised, parallel group study in 52 subjects was conducted (32 men, mean age 20 ± 9 years) with clinically- and laboratory-confirmed AA respiratory allergies (allergic rhinitis with or without mild-to-moderate asthma). Patients were randomly assigned to SLIT treatment (SLITone Alternaria, ALK-Abellò, Denmark) one vial per day without up-dosing for 3 consecutive years (n = 34) or to a control group (n = 18) with a random allocation ratio of 2:1. Clinical improvement was assessed by evaluating patient-reported outcome (PRO) using a 6 cm visual analogue scale (0: extreme worsening; 3: no change; 6: extreme improvement). The VAS score was evaluated every year with an intra- and inter-group comparison. Rescue medication score (MS) was assessed by evaluating symptomatic drug consumption.Results:After 3 years the VAS score was 4.7 ± 0.8 in the SLIT group and 2 ± 1.6 in the control group (p = 0.0002). Clinical improvement was observed in 33 out of 34 subjects in the SLIT group (97%) and in 5 out of 18 in the control group (27%) (p = 0.0001; Fisher's exact test). The MS significantly (p = 0.0001) decreased in the SLIT group from 4.3 to 1.7 at the end of 3 years’ treatment. In the control group MS increased from 3.4 to 4.0 by the end of the trial. No serious adverse events were observed in the either group. Six patients in the SLIT group (17%) reported side-effects, in general mild and transient. One patient prematurely discontinued the treatment due to gastrointestinal discomfort.Conclusion:The current study has shown that a 3-year course of SLIT is efficacious and well-tolerated in subjects with AA respiratory allergies.

Sublingual immunotherapy in asthma does not influence lymphocyte sensitivity to fas stimulation

BackgroundThe resistance of T lymphocytes to Fas-mediated apoptosis is an important feature of atopic asthma. The only effective causative treatment of atopic diseases is immunotherapy. Clinical efficacy of sublingual immunotherapy (SLIT) has been already proven, but there is still limited number of studies on its influence on lymphocytes function.ObjectivesThe aim of the study was to evaluate whether SLIT could restore the sensitivity of asthmatic T cells to undergo Fas-mediated apoptosis.Materials and methodsPeripheral blood was collected from 12 patients aged 8 ± 2 years suffering from atopic asthma and undergoing sublingual specific immunotherapy. To evaluate sensitivity to Fas-mediated apoptosis, the blood was transmitted to sterile tubes and mixed with purified monoclonal antibody anti-CD95. After incubation, leukocytes were stained with Annexin V, propidium iodide, and monoclonal antibody against CD2 conjugated with phycoerythrincyanin 5.1, and then analyzed with flow cytometry. The procedure was repeated for each patient after 12 months of SLIT.ResultsStimulation with anti-CD95 of T lymphocytes from patients with atopic asthma before treatment increased the number of early apoptotic cells (from 19.5 ± 16.7% before stimulation to 26.6 ± 16.7% Annexin V positive cells after stimulation). After one year of SLIT anti-CD95 still caused an increase of the early apoptotic cells ratio in the lymphocyte population (from 12.4 ± 7.4% before stimulation to 24.7 ± 15.4% Annexin V positive T cells after CD95 stimulation). Although an increasing trend could be observed, differences between the analyzed groups were not statistically significant.ConclusionsA year of SLIT does not change the sensitivity of T lymphocytes from peripheral blood of children suffering from atopic asthma to Fas-mediated apoptosis.

Immunothérapie sublinguale : pour quel profil de patients en pratique ? Analyse intermédiaire d’Odissee (observatoire de l’indication, du choix de prise en charge par immunothérapie spécifique sublinguale ainsi que de l’adhésion et de l’observance au traitement chez les patients souffrant d’allergie respiratoire [rhinite et/ou conjonctivite et/ou asthme allergique

Analysis purpose This analysis has allowed to document, in a practical manner, the patients’ clinical and sensitization profiles, and to identify the grounds in establishing or not a specific sublingual immunotherapy (SLIT). Patients and methods National, longitudinal multicenter survey, performed in patients from 5 years old, whose allergy was confirmed by skin test or specific IgE testing. Sociodemographic data, history of allergy and the considered therapeutic approach were gathered in a registry from September 2009 to March 2010, and then analyzed. Results Amongst 4227 patients registered by 264 physicians, 62% were polysensitized, 80.4% had several symptoms of respiratory allergy, including rhinitis (98.2%) mostly persistent and with moderate to severe intensity; conjunctivitis (65,5%) and asthma (48.1%) intermittent in 69% of cases. About 94.3% of patients had symptomatic treatments, moderate or insufficient effectiveness for 68.5% of them. A SLIT has been initiated in 65% of cases. The presence of conjunctivitis and sensitization to Betulaceae or cypress pollen increased the probability of initiating a SLIT, whereas polysensitization was not a determinant factor. Insufficient symptomatic complain, patient's treatment refusal or predictable poor compliance were the main reasons for not initiating a SLIT. Conclusion The results of this registry have testified, in practice, the compliance with the ARIA recommendations in the decision establishing a SLIT: treatment was proposed to young patients suffering from moderate to severe rhinitis, with an important discomfort and inadequately relieved by symptomatic treatments.

Comparison of Specific Sublingual Immunotherapy to Homeopathic Therapy in Children with Allergic Rhinitis

Comparison of Specific Sublingual Immunotherapy to Homeopathic Therapy in Children with Allergic Rhinitis

Efficacy of sublingual specific immunotherapy in intermittent and persistent allergic rhinitis in children: an observational case–control study on 171 patients. The EFESO‐children Multicenter Trial

Sublingual-specific immunotherapy (SLIT) is considered as a valid treatment of respiratory allergies. However, there are few data on large sample size regarding its clinical role in 'real life' in term of reduction of symptoms, rescue medications and prevention of asthma in patients suffering from allergic rhinitis (AR) especially in children. We performed a multicenter, case-control study to evaluate the effect of SLIT in children (age 6-18 yr) with intermittent or persistent AR. 171 children (27% girls and 73% boys) with AR due to seasonal or perennial allergens were enrolled in a multicenter case-control study. Cases (n = 90) were defined as patients with intermittent (64%) or persistent (36%) AR who were treated for at least two consecutive years with specific SLIT with the related allergen extracts (SLITone ALK-Abellò). Controls (n = 81) were defined as sex-age- and type of allergen matched AR children who were never treated with specific immunotherapy and had no asthmatic symptoms at the beginning of observation period. Main outcomes of the study were the rhinoconjunctivitis symptom score (SS) (sneezing, rhinorrea, nasal itch, congestion, ocular itch and watery eyes) with a ranging scale from 0 (=no symptoms) to 3 (=severe symptoms) and the medication score (MS) evaluating symptomatic drug intake (antihystamine and inhaled corticosteroids). SS and MS were evaluated at the end of the observational period in relation with the period, considering the last 12 months, in which patients suffered the highest symptoms levels (i.e., peak of relevant pollen season (seasonal AR) or during the period of maximum allergen exposure in case of perennial AR). Secondary outcome of the study was the development of asthma symptoms during the observation period. SS (mean +/- SD) was 4.5 +/- 2.5 in cases and 9.0 +/- 3.0 in controls (-50%) (p = 0.0001). MS (mean +/- SD) was 2.5 +/- 1.9 and 3.6 +/- 2.1 in the case and control groups, respectively (-31%) (p = 0.0001). At the end of the observation period asthma symptoms were present in 14 subjects in the case group (15%) and in 20 children (24%) in the control group (p = 0.13). New skin sensitizations appeared in 6% of cases (n = 2) and in 36% (n = 12) of the controls (p = 0.001). The EFESO trial shows that a 2-yr once daily SLIT treatment in children with intermittent or persistent AR is associated with lower symptom and medication scores in comparison with subjects treated with symptomatic drugs only.

Specific sublingual immunotherapy with peach LTP (Pru p 3). One year treatment: a case report

AbstractIntroductionFood allergy is an increasing problem with limited therapeutic approaches apart from to the eviction diet.Case presentationA 40-year-old female patient with food allergy symptoms was polysensitized to almost all vegetable food since the age of 36; the onset of symptoms was during pregnancy. The allergological study demonstrated positive skin prick tests (SPT) to nuts, legumes, cereals, spices, several fresh fruits including peach, and other groups of vegetable foods however, it was negative to common aeroallergens. Serum specific IgE levels were negative (&lt;0.35 kU/L) to profilin and carbohydrate determinants, but positive to Pru p 3 (3.5 kU/L). Positive double-blind placebo-controlled food challenge to peach confirmed the allergic disease. She received specific sublingual immunotherapy with native Pru p 3 at a concentration of 40 μg/ml with 5 administrations per week and a cumulative dose of 200 μg of nPru p 3 per month. After an ultra-rush build-up phase concluded in one day she continued therapy during a year with 5 administrations per week. The clinical evolution and laboratory studies demonstrated an early reduction on SPT reactions with no relevant changes on serum specific IgE, IgG, IgG1and IgG4to Pru p 3 during the immunotherapy period. The challenge test was negative 4 months after the beginning of the SLIT. Regarding clinical response she markedly improved after the first month of treatment, and by the 3th month she had no major vegetable dietary restrictions, except for nuts and pepper.ConclusionThese results demonstrate the excellent efficacy and safety of sublingual specific protein immunotherapy developed according to the patient specific sensitivity profile to Pru p3.

Specific sublingual immunotherapy with peach LTP (Pru p 3). One year treatment: a case report.

IntroductionFood allergy is an increasing problem with limited therapeutic approaches apart from to the eviction diet.Case presentationA 40-year-old female patient with food allergy symptoms was polysensitized to almost all vegetable food since the age of 36; the onset of symptoms was during pregnancy. The allergological study demonstrated positive skin prick tests (SPT) to nuts, legumes, cereals, spices, several fresh fruits including peach, and other groups of vegetable foods however, it was negative to common aeroallergens. Serum specific IgE levels were negative (<0.35 kU/L) to profilin and carbohydrate determinants, but positive to Pru p 3 (3.5 kU/L). Positive double-blind placebo-controlled food challenge to peach confirmed the allergic disease. She received specific sublingual immunotherapy with native Pru p 3 at a concentration of 40 μg/ml with 5 administrations per week and a cumulative dose of 200 μg of nPru p 3 per month. After an ultra-rush build-up phase concluded in one day she continued therapy during a year with 5 administrations per week. The clinical evolution and laboratory studies demonstrated an early reduction on SPT reactions with no relevant changes on serum specific IgE, IgG, IgG1 and IgG4 to Pru p 3 during the immunotherapy period. The challenge test was negative 4 months after the beginning of the SLIT. Regarding clinical response she markedly improved after the first month of treatment, and by the 3th month she had no major vegetable dietary restrictions, except for nuts and pepper.ConclusionThese results demonstrate the excellent efficacy and safety of sublingual specific protein immunotherapy developed according to the patient specific sensitivity profile to Pru p3.

Untersuchung einer sublingualen Immuntherapie mit TOL SL® zur Behandlung von allergischer Rhinitis, allergischer Rhinokonjunktivitis und allergischem Asthma bronchiale unter Praxisbedingungen

Background: In recent years specific sublingual immunotherapy (SLIT) has received growing acceptance as an alternative to subcutaneous immunotherapy. Methods: A prospective post-marketing multicenter observational study with TOL SL® (Leti Laboratorios LETI, Spain) was conducted in 735 patients in Germany. The majority (66.9%) of the patients were suffering from allergic rhinoconjunctivitis. Assessments should take place at baseline, after 2 - 3 and 12 months of SLIT. The build-up phase lasted for 12 days followed by a maintenance phase of at least 12 months. Results: Oral swelling was reported by 14.6% and oral burning by 21.2% of the patients. In 2 patients (0.3%) the therapy was discontinued due to local reactions. Overall tolerability was assessed as very to good by the physicians in 93.6 and by 91.2% of the patients. Similar ratings for efficacy of the therapy were given by the physicians in 85.9 and by 82.6% of the patients and 95% each appreciated the practicability of the substance administration and the therapy regimen. Conclusion: In the present study TOL SL® was safe and well-tolerated in the control of allergic diseases in everyday practice.

Evaluation of a compliance device in a subgroup of adult patients receiving specific immunotherapy with grass allergen tablets (GRAZAX ®) in a randomized, open-label, controlled study: An a priori subgroup analysis

Objectives: This a priori subgroup analysis was conducted to assess patients' experience with a compliance device for the administration of sublingual specific immunotherapy for grass pollen-induced rhinoconjunctivitis. Methods: The present paper reports the results of a subgroup analysis of a multicenter, randomized, controlled, open-label European study in which adults with grass pollen-induced rhinoconjunctivitis received once-daily treatment with grass allergen tablets with or without a device to aid compliance. Treatment was given ~6 to 12 weeks before the grass pollen season, during the season (~8–10 weeks), and for up to 2 weeks after the end of the season. In the subgroup analysis, patients from Germany and the Netherlands who had been randomized to receive the compliance device were asked to complete a brief questionnaire at the final study visit. The questionnaire included 6 items concerning patients' use of the device and whether it helped them remember to take their tablets. Results: Of the 91 patients from Germany and the Netherlands who were randomized to use the compliance device along with grass allergen tablets, 71 returned the questionnaire. Among responders, 58 of 71 (82%) reported using the device sometimes or always, 50 of 63 (79%) found the device easy to use, 32 of 69 (46%) found that the device made it easier to remember to take tablets, and 43 of 71 (61%) indicated that they would consider using the device again. Conclusion: Most patients in this subgroup analysis used the compliance device as a medication reminder and rated it easy to use.

Sublingual Immunotherapy Efficacy In Children With Atopic Eczema (ae) And House Dust Mites Sensitivity: A Prospective Open Study

Specific immunotherapy (SIT) with house dust mite (HDM) extract has recently been shown to improve eczema in adult patients with atopic dermatitis (AD). So far, there are less data regarding efficacy and safety of SIT in children with AD. Therefore, we evaluated in an open prospective pilot trial the effect of sublingual SIT (SLIT) with HDM allergen exstract preparation on Severity Scoring of Atopic Dermatitis (SCORAD) index in children with mild-moderate AE.

Allergen specific immunotherapy for atopic dermatitis

To describe recent developments as well as the pros and cons of allergen specific immunotherapy as a putative therapeutic option for a subgroup of patients with atopic dermatitis. The question whether specific immunotherapy would impair or improve the severity and course of atopic dermatitis has been a matter of debate for a long time. Double-blind placebo-controlled studies on the safety and efficacy of subcutaneous and sublingual specific immunotherapy in atopic dermatitis are rare; however, a systematic review of the literature on all published studies on specific immunotherapy in atopic dermatitis, together with the results of the most recent controlled studies, provides promising results. The review discusses developments and recent advances in the field of specific immunotherapy as a causal therapy of sensitizations in atopic dermatitis. The most promising approaches, outlining putative immunologic as well as clinical changes which might go along with specific immunotherapy in atopic dermatitis patients, are highlighted. Further, we discuss how upcoming clinical studies and research could help to open new avenues for specific immunotherapy as a treatment for atopic dermatitis in the near future.