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SLIT improves symptoms in patients with grass pollen-induced allergic rhinitis

Sublingual immunotherapy with a five-grass pollen tablet improved symptoms in adults with allergic rhinitis, according to results of a prospective, multicenter study.

Sublingual immunotherapy (SLIT) also appeared associated with few adverse reactions, results showed.

“Our data indicated that the five-grass pollen tablet was associated with both good tolerability and symptom relief (including considerably less symptomatic medication use),” Oliver Pfaar, MD, of the Center for Rhinology and Allergology Wiesbaden in Germany, and colleagues wrote. “Despite the difference in atmospheric grass pollen levels between the season preceding SLIT and the first season of SLIT — which made it difficult to draw definitive conclusions on effectiveness — the stated degree of symptom relief suggests that SLIT was indeed associated with clinical benefits.”

Pfaar and colleagues evaluated 808 (55% women; median age 34.7 years) patients treated at one of 354 participating centers. All participants had moderate to severe allergic rhinitis, and they received at least one five-grass pollen tablet between September 2008 and December 2009.

The tablet contained freeze dried samples of orchard (Dactylis glomerata), meadow (Poa pratensis), perennial rye (Lolium perenne), sweet vernal (Anthoxanthum odoratum) and timothy (Phleum pratense) grasses. Patients received increasingly larger doses until they were taking one full tablet daily.

Seventy-one percent of the patients received a pre-seasonal regimen between November and February.

Researchers classified 84.9% of patients as responders, meaning they reported lesser severity of their symptoms. Approximately one-fourth of patients reported an absence of symptoms.

Results showed 13.1% of patients reported no change in their symptoms, and 2.1% of patients reported worsening symptoms during the study period.

Researchers reported response rates of 76.8% among patients with eye symptoms, 73.3% among patients with concomitant bronchial symptoms and 71.8% of patients among those with skin symptoms.

More than half of all adverse drug reactions reported during the study occurred during administration of the first five-grass pollen tablet.

Researchers reported 204 (25.5%) patients experienced a combined 419 adverse reactions during administration of the first tablet. Reactions during the initial administration included gastrointestinal disorders — such as a reaction at the application site (20%), oral paresthesia (9.7%) and oral pruritus (6.2%) — as well as respiratory, thoracic and mediastinal disorders (8.5%).

After administration of the initial five-grass pollen tablet, most adverse reactions were mild to moderate in severity. – by Jeff Craven

Disclosure: Please see the full study for a complete list of all researchers’ relevant financial disclosures.