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| |  Sublingual Allergen-Specific Immunotherapy Comparable With Subcutaneous Therapy in Daily Routine: Presented at EAACI By Judith Moser, MD WARSAW, Poland -- June 11, 2009 -- According to a meta-analysis presented here at the 28th Congress of the European Academy of Allergy and Clinical Immunology (EAACI), both subcutaneous (SCIT) and sublingual allergen-specific immunotherapy (SLIT) lead to substantial reductions in rhinitis and conjunctivitis symptoms in patients with grass pollen allergy, but the probability for systemic or anaphylactic reactions is higher with the subcutaneous administration. "We performed an individual patient data meta-analysis of 2 observational prospective studies to investigate whether the data from the studies is comparable to the observations in daily clinical practice," said Jochen Sieber, MD, Medical Department, Stallergenes GmbH, Kamp-Lintfort, Germany, when presenting the analysis here on June 8. One study assessed a preseasonal treatment start and perennial continuation of SCIT (n = 110) and the other a pre-/co-seasonal treatment with SLIT (n = 305). "Patients rated the severity and frequency of their rhinitis and conjunctivitis symptoms," Dr. Sieber explained. Substantial improvements became apparent in both groups already during the first pollen season. In the SLIT group, the proportion of patients with frequent or very frequent rhinitis symptoms decreased from 81.8% to 24.3%. Correspondingly, the percentage of patients experiencing symptoms only rarely or sometimes rose from 18.8% to 75.7%. For SCIT, the proportion of patients experiencing frequent rhinitis symptoms decreased from 89.6% to 25.0%, and the percentage of patients who had only infrequent symptoms increased from 10.5% to 75.0%. Sixty percent of patients in the SLIT group and 71.8% of those in the SCIT group rated their rhinitis symptoms as severe before treatment; these figures were reduced to 6.8% and 8.9%, respectively. Similar decreases were seen in both groups in terms of frequency and severity of conjunctivitis symptoms. "The total rhinoconjunctivitis score was significantly reduced in both groups by about 50%," Dr. Sieber said (P < .001 with both SLIT and SCIT). "There was no significant difference between the 2 treatment forms." Adverse events occurred mainly during the titration phase and abated during the maintenance phase. This observation matches the known event pattern. With SLIT, the most frequent symptoms were swelling and burning in the oral cavity. Erythema and pain at the injection site were the most frequent symptoms in the SCIT group. As Dr. Sieber pointed out, no severe systemic or anaphylactic reactions arose with the SLIT treatment, whereas with SCIT, one severe systemic reaction and one anaphylactic reaction occurred during the titration phase. "In terms of efficacy, SCIT and SLIT are comparable," Dr. Sieber summarised. "As SLIT appears more tolerable, we think that it should be used preferentially for the treatment of pollen allergies." Funding for this study was provided by Stallergenes GmbH. [Presentation title: Grass Pollen SIT in Daily Medical Practice -- Effectiveness of Sublingual Immunotherapy Is Comparable With Subcutaneous Treatment. Abstract 894]
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