Allergy Immunotherapy Adherence and Delivery Route: Location Does Not Matter

Cox, Linda; Hankin, Cheryl S.; Lockey, Richard F.

doi:10.1016/j.jaip.2014.01.010

Cited by 71 publications

(54 citation statements)

References 67 publications

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“…Studies on SLIT adherence (generally defined as taking ‡80% of prescribed medication) have reported rates of between 29 and 91% over 2 or 3 years of treatment [31]. Factors that have been shown to be important for adherence to AIT include cost; inconvenience; feelings of inefficacy; adverse events (AEs); patient, parent and physician education and number of followup visits [21,32].…”

Section: Abstract: 5-grass-pollen Tablet • Allergic Rhinitis • Allergmentioning

confidence: 99%

“…In an indirect comparison, grass-pollen SLIT tablets had a greater mean relative clinical impact than second-generation H 1 -antihistamines and montelukast, and the same mean relative clinical impact as nasal corticosteroids [27]. Moreover, SLIT with a 5-grass-pollen allergen tablet for three consecutive pollen seasons has been shown to provide a sustained benefit in terms of symptom control and QoL, for at least 2 years after discontinuation of treatment [28][29][30], thus demonstrating long-term disease remission and modification that is consistent with the induction of antigen-specific tolerance [21].Studies on SLIT adherence (generally defined as taking ‡80% of prescribed medication) have reported rates of between 29 and 91% over 2 or 3 years of treatment [31]. Factors that have been shown to be important for adherence to AIT include cost; inconvenience; feelings of inefficacy; adverse events (AEs); patient, parent and physician education and number of followup visits [21,32].…”

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confidence: 99%

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Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience

Didier

Wahn

Horak

et al. 2014

Expert Review of Clinical Immunology

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OralairÒ (OA) (Stallergenes, Antony, France) is a unique pre-and co-seasonal 5-grass-pollen sublingual immunotherapy tablet launched in 2008, and now approved in 31 countries worldwide for the treatment of grass-pollen allergic rhinitis and rhinoconjunctivitis. OA is the first oral treatment with a consistent, well-balanced allergen extract that mimics natural exposure and sensitization. A wealth of data exists from over 5 years of clinical and realworld experience demonstrating the efficacy and safety of OA for grass-pollen-allergy treatment. OA is highly effective from the first pollen season in all patient subgroups, including children and those with comorbid mild asthma, irrespective of sensitization status and symptom severity. OA also has sustained long-term benefits for symptom control and quality of life. This article provides an overview of the pharmacodynamics and pharmacology of OA; its efficacy, safety, tolerability and cost-effectiveness for the treatment of allergic rhinitis and rhinoconjunctivitis and its role in clinical practice. Allergic rhinitis (AR) is a common chronic inflammatory illness, characterized by rhinorrhea, nasal congestion, sneezing, nasal and ocular pruritis and watery eyes [1]. Inhalation of allergens by sensitized individuals triggers the IgE-mediated release of inflammatory mediators and cytokines, leading to a rapid appearance of symptoms [2]. AR has historically been classified as 'seasonal' or 'perennial' depending on whether symptoms occur with seasonal exposure to aeroallergens or are present throughout the year. Seasonal AR is most commonly attributed to plant pollen and other outdoor allergens, while perennial AR is associated with indoor allergens, such as dust mites, mold, cockroaches and pet dander, although it can also be associated with pollen in areas where this is prevalent year-round [3,4].In 2001, the WHO-sponsored Allergic Rhinitis and its Impact on Asthma meeting produced guidelines proposing an alternative classification of the condition into 'intermittent' or 'persistent' AR, and grading symptoms as 'mild' or 'moderate/severe' [5]. Globally, the prevalence of seasonal ('hay fever') and perennial AR ranges from 7 to 42 and 1 to 13%, respectively, with the former being more common in children than adults [6]. The length of exposure to seasonal allergens is dependent on geographic location and climatic conditions [4]; in Europe, the main pollen season typically occurs from March to July, with slight variations according to latitude [7].Approximately 500 million people worldwide [6], including an estimated 30-60 million in the USA [4] 1309Drug Profile suffer from AR, and its prevalence is increasing in most countries [2]. It is estimated that from 10 to 30% of adults and up to 40% of the pediatric population have AR [3,9]. While AR does not directly lead to mortality, it places a considerable burden on affected individuals, who often have a reduced quality of life (QoL), compared with non-sufferers [10]. The physical symptoms of AR can cause sleep disturbance...

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Section: Abstract: 5-grass-pollen Tablet • Allergic Rhinitis • Allergmentioning

confidence: 99%

mentioning

confidence: 99%

Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience

Didier

Wahn

Horak

et al. 2014

Expert Review of Clinical Immunology

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“…Other routes of administration have been developed, 17 like the sublingual route (SLIT), to circumvent some of above inconveniences, particularly in children; however, when the issue of compliance has been addressed, it appears that SLIT is not favored over injected SCIT. 18 The intradermal injection route, 19 may off er the possibility of using lower allergen dosing while…”

Section: Introductionmentioning

confidence: 99%

Intradermal immunotherapy with low-dose house dust mite allergens in patients with allergic rhinitis: A proof-of-concept study

Vieira-Hernández¹,

Capriles‐Hulett²,

Sánchez‐Borges³

et al. 2018

RAM

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Antecedentes: La inmunoterapia subcutánea acuosa a altas dosis es una ruta validada y efectiva de administración de alérgenos para el ácaro del polvo doméstico y alergias al polen.Objetivos: Estudio de definición conceptual empleando inmunoterapia intradérmica (ITID) con alérgenos de ácaros (Dermatophagoides pteronyssinus/Dermatophagoides farinae [Dp/Df] y Blomia tropicalis [Bt]) a bajas dosis; se llevó a cabo en niños con rinitis alérgica sintomáticos a la exposición de polvo de casa. Métodos: A ocho pacientes sin uso previo de inmunoterapia, con pruebas de punción cutánea positivas e IgE sérica específica a una mezcla de Dp/Df y Bt, se les administraron por tres meses 0.05 mL de ITID semanalmente, provenientes de una preparación fenolizada albúmino-salina y contentiva de bajas dosis de ácaros (8.3 AU= 5 ng de Dp/Df y 2.5 DBU de Bt). Los síntomas nasales (Total Nasal Symptom Score) y los faciales (Escala Análoga Visual) fueron registrados dos semanas antes del tratamiento y en el transcurso una vez a la semana. Al comienzo y al final se realizaron pruebas cutáneas diluidas y seriadas (1/100-1/1.000.000) y determinaciones de IgG4 en el suero para los alérgenos. Resultados: Los valores de las escalas sugirieron mejoría clínica. Existió disminución significativa de los diámetros de las pápulas de las pruebas diluidas y seriadas, así como aumento de los valores de la IgG4 sérica al final del tratamiento. La ITID fue bien tolerada.Conclusión: Si estudios ulteriores confirman los presentes hallazgos, se podría promover una mayor utilización de la inmunoterapia alérgeno-específica.

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“…This problem affects both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), even if some data suggest that adherence is better in patients receiving SCIT [3]. Other than clinical reasons, one of the most relevant factors for poor adherence to SCIT is the inconvenience related to the commute necessary to receive the allergy injections [4]; consequently, many attempts have been made to shorten treatment by reducing the number of injections [5].…”

mentioning

confidence: 99%

“…Patients can benefit earlier from the treatment, since the clinical benefits of AIT appear very shortly after the maintenance dose is reached [5]. Shortening the escalation period can also address the problem of poor adherence, since adherence to SCIT is affected by logistic difficulties in attending the health care facility to receive the medication [4]. It is interesting to make a comparison of our findings with the results of the phase II randomized study by Chaker et al [9], who compared the safety and tolerability of the same short build-up schedule with the same 6-grass allergoid extract, which shared features with the classic 7-injection schedule [9].…”

mentioning

confidence: 99%

Safety of an Accelerated Build-up Phase With Pollen Allergoids: A Retrospective Study

Borgonovo

Bramé

Cocconcelli

et al. 2018

J Investig Allergol Clin Immunol

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283We sent a questionnaire to allergy centers that adopted the shortened build-up schedule. The questionnaire included the following items: age, gender, symptoms, extract composition, maximum dose reached (yes/no), number of injections, local reactions (>5 cm, <10 cm), large local reactions (>10 cm), and systemic reactions. The shortened regimen was administered with Allergovit (Allergopharma GmbH & Co. KG), an AIT pollen extract that has been chemically modified with formaldehyde to produce an allergoid. Allergovit is specified in therapeutic units per mL (TU/mL) and provided in 2 strengths (A, 1000 TU/mL; and B, 10 000 TU/mL). The abbreviated updosing regimen consists of 4 injections, and the schedule is completed within 3 weeks only, while the conventional regimen comprises 7 injections. Patients received 2 weekly strength A injections and 2 strength B injections, with volumes of 0.2 and 0.6 mL, respectively. In grass pollen Allergovit extracts, the maximum dose of 0.6 mL corresponds to a content of 25 μg of grass group 5 allergens. The Figure shows a comparison of the classic and abbreviated build-up schedules.We collected 156 cases of patients with seasonal allergic rhinoconjunctivitis who had been chosen for the short buildup; 85 of these patients also had asthma symptoms. Mean age was 36.0 years (range, 7-76), and there were 89 males and 67 females. The distribution by extract was as follows: grasses, 46; Parietaria, 36; ragweed, 26; birch, 13; mixed trees, 10; various mixtures, 25.All patients but one reached the maximum scheduled dose, and 138 patients (88.5%) completed the treatment without reactions. A further 138 patients (88.5%) also reached the maximum dose with the 4 scheduled injections. Eighteen patients required 1 extra injection, 9 for concomitant nontreatment-related events and 9 for adverse reactions.Overall, 12 mild treatment-related local reactions (>5 cm, <10 cm) and 2 severe local reactions (>10 cm) were recorded (2.2% of the total 649 injections; 9.0% of patients). A severe local reaction was the reason why 1 patient did not reach the maximum dose. No systemic reactions were observed.

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Allergy Immunotherapy Adherence and Delivery Route: Location Does Not Matter

Cited by 71 publications

References 67 publications

Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience

Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience

Intradermal immunotherapy with low-dose house dust mite allergens in patients with allergic rhinitis: A proof-of-concept study

Safety of an Accelerated Build-up Phase With Pollen Allergoids: A Retrospective Study

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