A randomized <scp>DBPC</scp> trial to determine the optimal effective and safe dose of a <scp>SLIT</scp>‐birch pollen extract for the treatment of allergic rhinitis: results of a phase <scp>II</scp> study

Pfaar, Oliver; Twuijver, Esther van; Boot, J. D.; Opstelten, Dirk Jan E.; Klimek, L.; Ree, Ronald van; Diamant, Zuzana; Kuna, Piotr; Panzner, Petr

doi:10.1111/all.12760

Cited by 44 publications

(39 citation statements)

References 31 publications

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“…The differences were statistically significant. This study outcome raises questions about the efficacy of SLIT itself 19. Hence, nonperception of efficacy is strongly supported as a reason for nonadherence with this outcome.…”

Section: Discussionmentioning

confidence: 82%

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Sublingual versus subcutaneous immunotherapy: patient adherence at a large German allergy center

Lemberg¹,

Berk²,

Shah‐Hosseini³

et al. 2017

PPA

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BackgroundMany placebo-controlled studies have demonstrated that allergen immunotherapy (AIT) is an effective therapy for treating allergies. Both commonly used routes, subcutaneous (SCIT) and sublingual immunotherapy (SLIT), require high patient adherence to be successful. In the literature, numbers describing adherence vary widely; this investigation compares these two routes of therapy directly.MethodsAll data were retrieved from the patient data management system of a center for dermatology, specific allergology, and environmental medicine in Germany. All 330 patients (aged 13–89 years) included in this study had commenced AIT between 2003 and 2011, thus allowing a full 3-year AIT cycle to be considered for each investigated patient.ResultsIn this specific center, SCIT was prescribed to 62.7% and SLIT to 37.3% of all included patients. The total dropout rate of the whole patient cohort was 34.8%. Overall, SLIT patients showed a higher dropout rate (39.0%) than did SCIT patients (32.4%); however, the difference between these groups was not significant. Also, no significant difference between the overall dropout rates for men and for women was observed. A Kaplan–Meier curve of the patient collective showed a remarkably high dropout rate for the first year of therapy.ConclusionThe analysis presented in this single-center study shows that most patients who discontinue AIT do so during the first year of therapy. Patients seem likely to finish the 3-year therapy cycle if they manage to adhere to treatment throughout the first year. Strategies for preventing nonadherence in AIT, therefore, need to be developed and standardized in future investigations.

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Section: Discussionmentioning

confidence: 82%

“…One starting point for an explanation, however, could be the lack of standardized SLIT dosages. Pfaar et al19 have just reported in a dose-finding study that the most efficient SLIT dose has not yet been established for birch tree pollen. They found that the higher the dosage of birch allergens, the better the symptom scores and improvement.…”

Section: Discussionmentioning

confidence: 99%

Sublingual versus subcutaneous immunotherapy: patient adherence at a large German allergy center

Lemberg¹,

Berk²,

Shah‐Hosseini³

et al. 2017

PPA

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“…The body of clinical evidence will increase and lead to more products with documented efficacy and safety. In veterinary medicine, central to the above is answering the question “what is the optimal dose of allergen extract in dogs?” Dose‐dependency of ASIT efficacy has been long‐observed in human trials and recent mouse models . Not only the absolute dose, but also the dosing intervals have measurable effects on efficacy under some circumstances.…”

Section: Review Of Current Approaches To Asit In Dogs: How Well Does mentioning

confidence: 99%

“…Dose-dependency of ASIT efficacy has been longobserved in human trials and recent mouse models. 26,27 Not only the absolute dose, but also the dosing intervals have measurable effects on efficacy under some circumstances. Unfortunately, these effects remain unstudied for ASIT in animals.…”

Section: Review Of Current Approaches To Asit In Dogs: How Well Does mentioning

confidence: 99%

The future of immunotherapy for canine atopic dermatitis: a review

DeBoer

2017

Veterinary Dermatology

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Allergen specific immunotherapy (ASIT) is a foundation treatment for canine atopic dermatitis (CAD), though few critical studies have documented its effectiveness as a disease-modifying treatment in dogs. The mechanisms by which ASIT works in dogs have not been elucidated, although they are likely to parallel those known for humans. Current ASIT approaches in CAD focus on either subcutaneous or sublingual administration. Greater knowledge of major allergens in dogs, ideal dosage regimes and details of allergen admixture are likely to lead to better efficacy in CAD. Evaluation of biomarkers for successful therapy may also be of benefit. Potentially important advances in human medicine, that have yet to be explored in dogs, include use of modified allergen preparations such as allergoids, recombinant major allergens or allergen peptides; modification with adjuvants; or packaging of the above in virus-like particles. Co-administration of immunomodulators such as CpG oligodeoxynucleotides or specific monoclonal antibodies might direct the immune response in the desired direction while calming the "cytokine storm" of active disease. Initial trials of alternative routes of administration such as intralymphatic immunotherapy have yielded exciting results in humans, and continuing study in dogs is underway. Progress in ASIT of human food allergy may provide clues that will assist with improved diagnosis and patient management of CAD. Importantly, further study must be undertaken to clarify the conditions under which ASIT is a valuable treatment modality for dogs.

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“…Dosedependency of ASIT efficacy has been long-observed in human trials and recent mouse models. 26,27 Not only the absolute dose, but also the dosing intervals have measurable effects on efficacy under some circumstances. Unfortunately, these effects remain unstudied for ASIT in animals.…”

Section: Review Of Current Approaches To Asit In Dogs: How Well Does mentioning

confidence: 99%

The future of immunotherapy for canine atopic dermatitis: a review

DeBoer

2017

Advances in Veterinary Dermatology

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A randomized DBPC trial to determine the optimal effective and safe dose of a SLIT‐birch pollen extract for the treatment of allergic rhinitis: results of a phase II study

Cited by 44 publications

References 31 publications

Sublingual versus subcutaneous immunotherapy: patient adherence at a large German allergy center

Sublingual versus subcutaneous immunotherapy: patient adherence at a large German allergy center

The future of immunotherapy for canine atopic dermatitis: a review

The future of immunotherapy for canine atopic dermatitis: a review

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