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Dosage escalation of SCIT safe, tolerable

Patients who received an escalated dosage of subcutaneous immunotherapy across a decreased number of weekly injections tolerated the escalation well with a good safety profile, according to results from an open label phase 2 trial.

“The dose escalation scheme of a grass pollen allergoid can be accelerated from the conventional 7–4 injections in weekly intervals with comparable safety and tolerability profiles,” Adam M. Chaker, MD, of the department of otolaryngology and ZAUM at the Technische Universität and Helmholtz Center Munich in Germany, and colleagues wrote. “This accelerated dose escalation is expected to attract more patients to undergo SCIT and benefit from its clinical and immunological effects.”

Chaker and colleagues randomly assigned 122 adult patients 1:1 into one of two groups. Group one received SCIT using a grass pollen allergoid on an accelerated schedule comprising four weekly injections. The second group received conventional dose escalation comprising seven weekly injections. Researchers used a mixture of six different allergens: Holcus lanatus, Dactylis glomerata, Lolium perenne, Phleum pratense, Poa pratensis, and Festuca pratensis.

Twenty-two (36.1%) patients in the accelerated group and 15 (24.6%) patients in the conventional group had adverse reactions, according to the abstract.

In the accelerated group, 18 patients reported local reactions; five patients reported grade 1 systemic reactions; and three patients reported grade 2 reactions.

The conventional group reported 11 local reactions; two grade 1 systemic reactions; and two grade 2 reactions.

For the accelerated group, researchers rated 53 (86.9%) patients’ SCIT tolerability as good or very good vs. 59 (100%) patients in the conventional group, according to the abstract. Similarly, 48 (80%) patients in the accelerated group and 54 (91.5%) patients in the conventional group rated the tolerability as good or very good. – by Jeff Craven

Disclosure: Chaker reports receiving grants from Allergopharma GmbH & Co. KG, Germany and paid consultant roles with ALK, German Environmental Agency, Mundipharma, Novartis and Zeller AG. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.