Short Course Immunotherapy Containing Monophosphoryl Lipid A Adjuvant Shows Good Long-Term Efficacy: Presented at EAACI

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Title: Short Course Immunotherapy Containing Monophosphoryl Lipid A Adjuvant Shows Good Long-Term Efficacy: Presented at EAACI
URL: http://www.pslgroup.com/dg/223596.htm
Doctor's Guide
June 10, 2008

By Chris Berrie

BARCELONA, Spain -- June 10, 2008 -- An ultra-short course of subcutaneous immunotherapy (uSCIT) with a preseasonal pollen-allergy vaccine containing monophosphoryl lipid A adjuvant has favourable long-term effects for patients with pollen-related rhinoconjunctivitis without or with asthma, according to results of an open-label analysis.

This treatment also shows that few patients develop new respiratory symptoms, de-novo asthma, or clinically relevant pre-existing or new sensitisations during long-term follow-up.

This open study was presented by principal investigator Gabriele Fiedler, MD, Private Dermatology Practice, Weissenfels, Germany, here on June 8 at the 27th Congress of the European Academy of Allergology and Clinical Immunology (EAACI).

According to Dr. Fiedler, immunotherapies now offer prolonged symptom relief through specific targeting of the underlying allergic processes. Recently, uSCIT has been introduced to avoid the need for long treatment courses and numerous injections, as a valuable alternative to the standard approach.

To examine the efficacy of a preseasonal pollen-allergy vaccine administered through a uSCIT in patients with rhinoconjunctivitis, Dr. Fiedler conducted an open study over a minimum treatment period of 4 consecutive pollen seasons.

A total of 277 patients (median age, 33 years; male, 46%) were treated with 4 preseasonal injections per year of increasing doses of the pollen-allergy vaccine at doses of 300, 800, 2,000, and 2,000 SU adjuvanted with monophosphoryl lipid A 50 mcg administered at weekly intervals. The numbers of patients completing this treatment with follow-up from the first to fourth consecutive pollen seasons for each of the 4 doses were: 132, 93, 42, and 13 patients, respectively.

At baseline, these patients showed a range of pollen sensitivities, with grass and rye (39%), and birch (22%) predominating, but included mugwort, alder, and hazel in various combinations.

Over the 4-season follow-up period, the proportion of patients requiring little or no symptomatic treatment remained for each season were 90%, 93%, 88%, and 85% from the first to the fourth season. Percentages of patients with improved symptom severity from baseline in the 4-dose groups were 99%, 99%, 100%, and 100%. The remaining patients reported their symptoms as much improved over these 4 seasons.

Further patient benefit was seen with up to 10% of patients developing new respiratory symptoms each season, and up to 7% developing asthma for the first time each season (new asthma: 5%, 1%, 5%, and 0% from the first to the fourth season).

Over the 4 seasons of follow-up, 1 patient acquired new sensitisation (second season), and 1 patient with an existing sensitisation developed clinically relevant rhinoconjunctivitis.

Dr. Fiedler stressed, "The clinical effects are stable post-treatment over many years, and this is a very practical therapy for me, as I can treat many patients in a short time, and the efficacy is very high for the patients."

Funding for this study was provided by Allergy Therapeutics.

[Presentation title: Long-Term Efficacy of Short Course Subcutaneous Immunotherapy Containing Monophosphoryl Lipid A Adjuvant Administered in a Clinical Setting. Abstract P1769]

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