Maintenance dosing for sublingual immunotherapy by prominent European allergen manufacturers expressed in bioequivalent allergy units

Larenas‐Linnemann, Désirée; Esch, Robert E.; Plunkett, Greg; Brown, S. C.; Maddox, Daniel E.; Barnes, Charles S.; Constable, Derek

doi:10.1016/j.anai.2011.07.001

Cited by 43 publications

(38 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 compared the protein content and the relative potency (ELISA) of various masked allergen extracts (among them D. pteronyssinus ) for SLIT from four European manufacturers. The allergenic content range was 2.8–24.0 μg/ml for Der p 1 and 0–7.7 μg/ml for Der p 2.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to previous composition studies 10, 15, 28, 30, products were purchased in a pharmacy so that they were provided in the same way patients receive them, and afterwards masking for blinding was applied. Our data indicate that two of the five studied extracts (Staloral 300 Rapid and SLITone ULTRA) are different from the rest.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding SLIT‐HDM allergens, both the dosages recommended by the different manufacturers in Europe 10 and the composition and quantification of the allergens 11 are diverse. Extracts are complex mixtures of biological materials, and each manufacturer uses a different reference unit (in‐house reference standard) to provide batch to batch consistency.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Variation in allergen content in sublingual allergen immunotherapy with house dust mites

Benítez

Espinazo-Romeu

Camacho

et al. 2015

Allergy

View full text Add to dashboard Cite

BackgroundAllergen immunotherapy is a treatment modality which can be applied using different vaccines. The aim of this study was to quantify and compare the allergen content of different house dust mites (HDM)’ sublingual treatments and to review the evidence on their efficacy.MethodsFive sublingual allergen immunotherapy (SLIT) products were ordered and purchased at an ordinary pharmacy and masked for blinding before the study was started. Detection of Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens Der p 1, Der f 1, Der p 2 and Der f 2 was carried out by immunoblotting and fluorescent multiplex. A literature search for meta‐analyses and systematic reviews that included SLIT‐HDM products was performed.ResultsDer p 1 concentrations ranged from 0.6 to 14.5 μg/ml; similar figures were found for Der f 1 that ranged from 0.2 to 12.4 μg/ml. Der p 2+ Der f 2 ranged from 0.2 to 1.5 μg/ml. Data on efficacy are scarce for most of the five products.ConclusionsSubstantial variations regarding allergen content were found among these five SLIT‐HDM products. Therefore, it can be necessary to guarantee the quality of the SLIT‐HDM products and to demonstrate their effectiveness before they are marketed. It seems necessary, for the moment, to take into account these characteristics of the products before prescribing.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Variation in allergen content in sublingual allergen immunotherapy with house dust mites

Benítez

Espinazo-Romeu

Camacho

et al. 2015

Allergy

View full text Add to dashboard Cite

show abstract

“…Only one uncontrolled before and after study pediatric study. However, many factors such as differences in allergen content, 141 administered volume, number of participants, and statistical power of the study may explain the differences between tablets and drop trials.…”

Section: Standardization Of Allergen Extractsmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

569

705

View full text Add to dashboard Cite

drawn on data from a systematic review of the literature, more recent published studies and multistakeholder expert clinical opinion. This Guideline is aimed at healthcare professionals who are encouraged to take the recommendations into account in the context of delivering clinical care. This Guideline is not a substitute for professional clinical judgment, which professionals need to exercise in the context of delivering personalised healthcare. AbstractAllergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach.The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass 766 | ROBERTS, PFAAR ET AL. tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children. | ME TH ODOLOGYThis Guideline was produced using the Appraisal of Guidelines forResearch & Evaluation (AGREE II) approach, 17,18 a structured approach to guideline production (see Table S1). This is designed to ensure appropriate representation of the full range of stakeholders, a careful search for and critical appraisal of the relevant literature, a systematic approach to the formulation and presentation of recommendations and steps to ensure that the risk of bias is minimized at each step of the process. The process started on April 2015 beginning with detailed face-to-face discussions agreeing on the process and the key clinical areas to address, followed by face-to-face meetings, and regular web conferences in which professional and lay representatives participated. | Clarifying the scope and purpose of the guidelinesThe scope of this EAACI Guideline is multifaceted...

show abstract

“…The same applies for immunotherapy vaccines, as recombinant allergens are currently not licensed for therapeutical use in humans, and all commercial immunotherapy products are extracts of the raw allergenic materials, containing variable levels of both allergenic and nonallergenic substances. Moreover, information is scarce regarding the relative concentration of specific allergens in natural extracts, either diagnostic or therapeutic, while methodological heterogeneity is the rule for the sporadically published reports [11,12,13] on the topic; this further complicates the issue of matching immunotherapy prescription to specific IgE-sensitization patterns and might at least partially account for some observed ineffectiveness in immunotherapy trials and in routine practice.…”

Section: Introductionmentioning

confidence: 99%

A Molecular Diagnostic Algorithm to Guide Pollen Immunotherapy in Southern Europe: Towards Component-Resolved Management of Allergic Diseases

Douladiris

Savvatianos

Roumpedaki

et al. 2013

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Correct identification of the culprit allergen is an essential part of diagnosis and treatment in immunoglobulin E (IgE)-mediated allergic diseases. In recent years, molecular biology has made important advances facilitating such identification and overcoming some of the drawbacks of natural allergen extracts, which consist of mixtures of various proteins that may be allergenic or not, specific for the allergen source or widely distributed (panallergens). New technologies offer the opportunity for a more accurate component-resolved diagnosis, of benefit especially to polysensitized allergic patients. The basic elements of molecular diagnostics with potential relevance to immunotherapy prescription are reviewed here, with a focus on Southern European sensitization patterns to pollen allergens. We propose a basic algorithm regarding component-resolved diagnostic work-up for pollen allergen-specific immunotherapy candidates in Southern Europe; this and similar algorithms can form the basis of improved patient management, conceptually a ‘Component-Resolved Allergy Management'.

show abstract

Maintenance dosing for sublingual immunotherapy by prominent European allergen manufacturers expressed in bioequivalent allergy units

Cited by 43 publications

References 34 publications

Variation in allergen content in sublingual allergen immunotherapy with house dust mites

Variation in allergen content in sublingual allergen immunotherapy with house dust mites

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

A Molecular Diagnostic Algorithm to Guide Pollen Immunotherapy in Southern Europe: Towards Component-Resolved Management of Allergic Diseases

Contact Info

Product

Resources

About