Comparison of efficacy, safety and immunologic effects of subcutaneous and sublingual immunotherapy in birch pollinosis: a randomized study.
ABSTRACT Sublingual immunotherapy (SLIT) is currently considered a valid option to subcutaneous immunotherapy (SCIT), but only a few studies made a direct comparison of their effectiveness. The aim of this study was to compare the clinical and immunological effects of SCIT and SLIT in pollinosis induced by Betulaceae.
Forty-seven adult patients were randomized to receive SCIT or SLIT, performed by Betulaceae (alder, birch, and hazel) extracts from Stallergenes (Antony, France) standardized in index of reactivity (IR) with the treatment schedules proposed by the producer. The clinical effects were established by symptom-medication scores recorded during the month of March. Side effects were reported directly by the physicians for SCIT and were registered in diary cards by the patients for SLIT. Immunologic evaluation was done by measuring specific IgE and IgG4 to Bet v 1.
Thirty-four patients (19 for SCIT and 15 for SLIT) completed the registration of symptoms and drug consumption during pollen period of Betulaceae. Mean cumulative doses of respectively 50.65 IR by SCIT and 4653.1 IR by SLIT were administered, with a SLIT/SCIT ratio of 92. There was no significant difference in mean symptom-medication score between SCIT and SLIT. Systemic reactions occurred in 16% of SCIT treated but in none of SLIT treated. As to immunologic evaluation, Bet v 1 specific IgE did not rise after the pollen season in SCIT treated, while increased non significantly in SLIT treated. Bet v 1 specific IgG4 increased in both treatment, buy only the increase with SCIT was significant (p = 0.001).
SLIT and SCIT with a ratio of about 100 are equally effective in controlling rhinoconjunctivitis caused by tree pollen allergy. SLIT is safer than SCIT, but does not show the same immunologic effects on serum specific IgE and lgG4 antibodies.
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ABSTRACT: SUBLIVAC FIX Birch (SUB-B) is a liquid oral preparation of Betula verrucosa pollen extract for the treatment of allergic rhinitis/rhinoconjuctivitis induced by birch pollen. The major allergen content of SUB-B and Staloral Birch (Stal-B) have been shown to be comparable. In order to compare the clinical efficacy and safety of both products, the present study was designed to investigate efficacy of treatment with SUB-B compared to Stal-B by means of reduction in allergy symptoms assessed by a titrated nasal provocation test (TNPT) in subjects suffering from IgE mediated allergy complaints triggered by birch pollen.07/2014; 4:23. DOI:10.1186/2045-7022-4-23
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ABSTRACT: Introduction: Ocular allergies comprise a spectrum of conditions that are underreported and underdiagnosed, and are frequently associated with rhinoconjunctivitis. Although allergic conjunctivitis is often not a sight-threatening condition, it could have a significant impact on a person's quality of life, morbidity and productivity. A variety of agents are available for the treatment of allergic conjunctivitis, including antihistamines, mast-cell stabilizers, dual action agents, glucocorticoids, calcineurin inhibitors and immunotherapy. Areas covered: The goal of this review is to investigate new therapeutic strategies for the treatment of ocular allergy. Within, the authors analyze the pharmacological management of allergic conjunctivitis and highlight Phase II clinical trial studies. Expert opinion: Recent findings about the pathophysiology of allergic conjunctivitis have enabled us to gain a better understanding of the molecular and cellular mechanisms of ocular disease. This, in turn, has led to the identification of novel targets, which, in turn, has led to the development of new therapeutic agents that are currently under evaluation in the first phases of clinical development. The most interesting agents, under development, are the new topical glucocorticoids, leukotriene receptor antagonists, resolvins, interleukin-1 receptor antagonists and integrin antagonists. The authors now await promising results, which can confirm the therapeutic value of these novel emerging drugs for treating allergic conjunctivitis.Expert Opinion on Investigational Drugs 07/2014; 23(12):1-16. DOI:10.1517/13543784.2014.944640 · 5.43 Impact Factor
Journal of Allergy and Clinical Immunology 09/2014; 134(3):765-765.e2. DOI:10.1016/j.jaci.2014.07.024 · 11.25 Impact Factor