To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Subcutaneous and Sublingual Therapies Equally Effective in Treating Tree- and Grass-Pollen-Related Rhinoconjunctivitis: Presented at EAACI URL: http://www.pslgroup.com/dg/2236FA.htm Doctor's Guide June 11, 2008
By Chris Berrie BARCELONA, Spain -- June 11, 2008 -- A multicentre, observational study comparing conventional subcutaneous immunotherapy (SCIT), ultra-short SCIT (uSCIT) and sublingual immunotherapy (SLIT) for patients with rhinoconjunctivitis demonstrated comparable good efficacy and safety for all 3 regimens, according to researchers here at the 27th Congress of the European Academy of Allergology and Clinical Immunology (EAACI). The aim of this study was to directly compare the efficacies and tolerabilities of SCIT, uSCIT, and SLIT regimens in treating patients with tree- and grass-pollen-related rhinoconjunctivitis, without or with asthma. "Although the gold standard in immunotherapy is long-term treatment, [with uSCIT] you can also give 4 injections in the autumn or winter, which might be better for patients in the long-term," said Dietrich Stollewerk, MD, Institute for Occupational and Environmental Medicine, Cologne, Germany, presenting a late-breaking abstract here on June 8. "No worldwide studies have compared these 3 regimens," he added. The cohorts examined conventional SCIT (n = 93), with a varying regimen of induction and maintenance injections administered throughout the year; uSCIT (n = 98), with 4 successive preseason injections, separated by at least 7 days and with allergen doses of 300, 800, 2,000, and 2,000 standardised units, each with 50 mcg/mL monophosphoryl lipid A; and SLIT (n = 18), with daily sublingual solution. All subjects had positive skin prick tests and medical history, with a questionnaire-based rhinoconjunctivitis severity score of 5 or greater and an asthma severity score of Global Initiative for Asthma (GINA) 1 or 2. Overall, 130 patients had tree-pollen-related rhinoconjunctivitis, and 79 had grass-pollen-related rhinoconjunctivitis. All 3 groups showed similar baseline demographics and rhinoconjunctivitis severities, however, the relative proportions of patients with asthma varied (GINA 1: 16.1%, 27.6%, 55.6% for SCIT, uSCIT, and SLIT, respectively; GINA 2: 7.5%, 21.4%, 27.8%, respectively). For efficacy, patients who were greatly improved or symptom-free were similar for all 3 treatment regimens for both tree- (36%, 45%, 38% for SCIT, uSCIT, and SLIT, respectively) and grass- (55%, 60%, 80%, respectively) pollen-related rhinoconjunctivitis, although the differences were seen within the asthmatics in each group (tree: 25%, 51%, 26%; grass: 50%, 53%, 28%). These primary outcomes were based on global physician and patient ratings, with symptom scores (0-3) recorded for rhinitis, conjunctivitis, and respiratory symptoms during the first season after treatment. The numbers of patients using symptomatic medication regularly during the pollen season were similarly reduced across these treatment regimens, for both tree- and grass-pollen-related rhinoconjunctivitis. The safety profile saw 28%, 19%, and 6% local effects across these treatment groups (SCIT, uSCIT, and SLIT) respectively, while patients reporting systemic effects (none severe) were all tree-pollen-allergic under conventional SCIT (9% of group): conjunctivitis (3 events), itching (3 events), rhinitis (1 event), difficulty breathing (1 event), and urticaria (1 event). Dr. Stollewerk stressed in particular the general non-inferiority of uSCIT compared to SCIT, according to the maximum likelihood method for longitudinal data, saying, "There is no difference in the effects for the short-term and the long-term regimens for these pollen allergies," with the imbalance in asthmatic patients probably accounting for the slight variations seen. Up to 30% of the European population, the authors noted, is affected by the increase in prevalence of allergic rhinitis. Dr. Stollewerk collaborated with Allergy Therapeutics plc for the purposes of this study. [Presentation title: Comparison of Efficacy of Conventional Subcutaneous Immunotherapy (SCIT), Ultra Short SCIT (uSCIT), and Sublingual Immunotherapy (SLIT): Results of a Multicentre Observational Study. Abstract P1751] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. 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