A short course of Cat-PAD improves the ocular and nasal components of rhinoconjunctivitis symptoms in subjects with cat allergy, with the treatment effect persisting 1 year after the start of treatment.

Background Sensitization to house dust mite (HDM) is a leading cause of allergic rhinitis and asthma. Despite more than 30 HDM‐derived allergens having been identified to date, specific therapeutic approaches do not yet take into account the local sensitization profiles of patients. This study aimed to identify patterns of HDM sensitization in HDM‐allergic adults living in distinct geographic areas, to inform the development of targeted diagnostic and therapeutic tools. Methods Serum samples from 685 HDM‐allergic subjects from Canada, Europe, South Africa, and the USA were tested for levels of IgE specific for 17 micro‐arrayed HDM allergens by ImmunoCAP Immuno Solid‐phase Allergen Chip (ISAC) technology. Results The results confirmed significant geographical variability in sensitization patterns and levels of IgE. In all areas, the major sensitizers were the group 1 and group 2 allergens and Der p 23. Der p 23 was a frequent sensitizer: 64% of the subjects had IgE specific for Der p 23, and 2.3% were monosensitized to it. In South Africa, Der p 23 was the dominant HDM allergen (86% prevalence) and Der p 7 achieved major allergen status (56%). IgE sensitization to HDM was influenced by asthmatic status, levels of allergen exposure, age, race‐ethnicity and smoking status, but not by BMI. Conclusion Sensitization profiles to HDM allergens differ considerably among distinct geographic areas, with Der p 7 and Der p 23 being major sensitizers in South Africa. Such heterogeneity should be taken into account in the diagnosis and treatment of HDM‐allergic patients.

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RATIONALE: Peanut allergy is a life-threatening condition for which there is currently no cure. Immunotherapy using whole peanut preparations is hindered by risk of causing severe allergic reactions during treatment. PVX108 is a peptide-based immunotherapy being developed to treat peanut allergy without triggering allergic reactions during treatment. METHODS: PVX108 comprises a mixture of short, synthetic peptides derived from sequences of major peanut allergens, formulated for intradermal injection. Basophil reactivity to PVX108 was assessed using blood samples from peanut allergic donors. Safety and tolerability of PVX108 was assessed in a randomized, double-blind, placebo-controlled phase I trial in peanut-allergic adults. Cohorts were randomized 2:1 to receive PVX or placebo. The first eight cohorts received a single injection. The dose was escalated for each successive cohort upon safe completion of the prior cohort. The ninth cohort received six injections at the highest dose (150nmol) over 16 weeks. RESULTS: Basophil assays confirmed lack of basophil reactivity to PVX108 in contrast to peanut extract in 146 peanut-allergic donors. The phase I trial enrolled a total of 66 subjects. There were no serious adverse events. Adverse events considered possibly or probably related to treatment were graded mild or moderate, with the majority being transient injection site reactions. None was deemed of clinical concern by the study Safety Review Committee. There was no relationship between dose level and frequency or severity of adverse events. CONCLUSIONS: Basophil reactivity and phase I data demonstrate that PVX108 has a highly favourable safety profile for treatment of peanut allergic individuals, including those with severe allergy. RATIONALE: Adrenaline auto-injector (AAI) dispensing data, a community-based proxy for number of individuals at risk of anaphylaxis, will provide complementary information on anaphylaxis risk in addition to hospital admission data. We examined trends of AAI dispensing in Australia over a 10 year-period (January 2005 to December 2014) and compared the prescription trends of dispensed AAI by different speciality of prescriber. METHODS: Patients with AAI were identified from a 10% random sample of Australian Pharmaceutical Benefits Scheme (PBS) data. PBS is the Australian national drug subsidy program. Cumulative incidence and incidence rates of patients with AAI were calculated using Australian population data. RESULTS: The cumulative incidence of patients with AAI in 2005-2014 was 75.43 per 100,000 person-years (95%CI 75.07-75.80). Males and children were more likely to be prescribed an AAI compared with females and adults. An increasing incidence rate was observed among the total population from 2005 to 2014 (from 71.47 to 82.07 per 100,000 personyears, P<0.001) although the magnitude of this increase varied by state. In most regions of Australia, there was a shift towards more prescriptions being provided by general practitioners (GP) and fewer provided by specialists such as allergi...