Once-daily sublingual allergen-specific immunotherapy improves quality of life in patients with grass pollen-induced allergic rhinoconjunctivitis: A double-blind, randomised study

Abstract

The effect of sublingual immunotherapy on quality of life (QoL) was examined in patients with grass pollen-induced rhinoconjunctivitis. Patients (n = 855) were randomised to once-daily grass allergen tablets (2,500; 25,000; or 75,000 SQ-T Phleum pratense extract; GRAZAX or placebo. Treatment was initiated 8 weeks before the start of the grass pollen season and continued throughout. If symptoms were present, patients received loratadine or placebo rescue medication. There were three major findings: in patients using loratadine, grass allergen tablets provided QOL benefits over placebo; Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score was 17% (p = 0.006) and 20% (p = 0.020) greater with 75,000 SQ-T tablet than with placebo at first and second seasonal visit, respectively; in patients not using loratadine, grass allergen tablets improved QoL more than placebo; RQLQ score was 21% greater (p = 0.021) with 75,000 SQ-T tablet at second seasonal visit; grass tablets (without loratadine) had a greater effect on QoL than loratadine alone. RQLQ score was 26% (p = 0.014) greater with 75,000 SQ-T tablets than loratadine at second seasonal visit. These data show that sublingual immunotherapy with grass allergen tablets improves QOL in allergic rhinoconjunctivitis, reduces symptoms, and that this effect is greater than rescue antihistamine alone.

Treatment Satisfaction During Routine Treatment with the SQ®-Standardised Grass Allergy Immunotherapy Tablet: A Non-interventional Observational Study

“…The TSQM score for side effects did not significantly increase, which is consistent with the finding in RCTs with the SQ Ò grass SLIT-tablet that local reactions at the oral mucosa observed in the majority of patients at the beginning of treatment tend to decline during the first 3 months of treatment [33].…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…Moreover, pivotal trials have been carried out and the results on over 600 patients showed convincingly that in grass pollen allergy, SLIT is safe and effective using tablets (1103,1712). Quality of life was improved in patients receiving SLIT (1713). Sublingual immunotherapy is effective for rhinitis and asthma induced by birch, cypress, grass, olive, Parietaria pollens and HDM.…”

Allergen-specific immunotherapy for respiratory allergies: From meta-analysis to registration and beyond

“…The quality of life of patients treated with SLIT is improved. 56,60 The size of these studies has allowed subgroup analyses showing, for example, that the beneficial effect does not vary according to the presence or absence of asthma and is similar in monosensitized and polysensitized patients. 61 It is interesting to note that low doses (25,000 standardized quality tablet [SQ-T] and 100 index of reactivity [IR], equivalent to 5-7 mg allergen Phl p 5 per day, according to the manufacturers) are ineffective and that a daily dose of around 15 to 25 mg is required to obtain a statistically significant clinical improvement in symptom scores.…”