Efficacy of grass pollen sublingual immunotherapy for three consecutive seasons and after cessation of treatment: the ECRIT study
Article first published online: 10 DEC 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Volume 64, Issue 1, pages 179–186, January 2009
How to Cite
Ott, H., Sieber, J., Brehler, R., Fölster-Holst, R., Kapp, A., Klimek, L., Pfaar, O. and Merk, H. (2009), Efficacy of grass pollen sublingual immunotherapy for three consecutive seasons and after cessation of treatment: the ECRIT study. Allergy, 64: 179–186. doi: 10.1111/j.1398-9995.2008.01875.x
- Issue published online: 23 DEC 2008
- Article first published online: 10 DEC 2008
- Accepted for publication 18 July 2008
Vol. 64, Issue 9, 1393, Article first published online: 14 SEP 2009
- allergic rhinitis;
- carry-over effect;
- grass pollen extract;
- sublingual immunotherapy;
- ultra-rush titration
Background: Data supporting a carry-over effect with sublingual immunotherapy (SLIT) are scarce. This randomized, double-blind, placebo-controlled study evaluated the efficacy, carry-over effect and safety of grass pollen SLIT using co-seasonal treatment.
Methods: Patients (7.9–64.7 years) with grass pollen allergy received ultra-rush titration with increasing doses (30, 90, 150 and 300 IR) of a 5-grass pollen mixture every 20 min at the start of the pollen seasons, followed by 300 IR daily until the end of the pollen seasons. A baseline season (no SLIT) was followed by three consecutive treatment seasons and one follow-up season. Symptoms, medication and adverse events were documented and specific immunoglobulin (Ig)E and IgG4 measured.
Results: Data were analysed for 183 of the 213 randomized patients. Mean treatment duration varied between seasons (81.8−92.7 days). Combined scores (symptoms and medication) improved progressively across treatment seasons (up to 44.7% improvement for SLIT compared with baseline) and fluctuated between −11.3% and −14.8% for placebo (P < 0.05). Similar changes were observed for symptom scores, with a successive decrease of 39.7% (SLIT) and fluctuations between +13.6% and −1.51% for placebo (P < 0.05). Combined score (P = 0.0508) and symptom score improvements (P = 0.0144) with SLIT continued during follow up. Increases in specific IgG4 observed in the first season were sustained for SLIT vs placebo throughout treatment (P = 0.0001). Titration and daily SLIT were well tolerated. No serious systemic or anaphylactic reactions were reported.
Conclusions: Seasonal SLIT with ultra-rush titration is well tolerated and effective from the first treatment season onwards. These data indicate a carry-over effect of seasonal SLIT.