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Sublingual immunotherapy

Anna Slovick, Abdel Douiri, Rachel Muir, Andrea Guerra, Konstantinos Tsioulos, Evie Hay, Emily P S Lam, Joanna Kelly, Janet L Peacock, Sun Ying, Mohamed H Shamji, David J Cousins, Stephen R Durham, Stephen J Till
BACKGROUND: Repeated low dose grass pollen intradermal allergen injection suppresses allergen-induced cutaneous late phase responses, comparable with conventional subcutaneous and sublingual immunotherapy. OBJECTIVE: To evaluate the efficacy and safety of grass pollen intradermal immunotherapy in the treatment of allergic rhinitis. METHODS: We randomly assigned 93 adults with grass pollen allergic rhinitis to receive 7 pre-seasonal intradermal allergen injections (containing 7 nanograms of Phl p 5 major allergen) or histamine control...
October 20, 2016: Journal of Allergy and Clinical Immunology
Ana Brotons-Canto, Nekane Martín-Arbella, Carlos Gamazo, Juan M Irache
Allergic diseases constitute one of the most common causes of chronic illness in developed countries. The main mechanism determining allergy is an imbalance between Th1 and Th2 response towards Th2. Areas covered: This review describes the mechanisms underlying the natural tolerance to food components and the development of an allergic response in sensitized individuals. Furthermore, therapeutic approaches proposed to manage these abnormal immunologic responses food are also presented and discussed. Expert opinion: In the past, management of food allergies has consisted of the education of patients to avoid the ingestion of the culprit food and to initiate the therapy (e...
October 12, 2016: Expert Opinion on Drug Delivery
Halie M Anderson, Robert A Wood, William W Busse
Allergic rhinitis (AR) is a common illness in children and can impair their quality of life. Furthermore, many children remain symptomatic despite maximizing systemic antihistamine and topical therapies. It is at this clinical juncture that immunotherapy may be considered. The efficacy and safety associated with both subcutaneous (SCIT) and sublingual (SLIT) approaches are reviewed and positioned as treatment options for pediatric patients, with specific focus on current literature as it relates to SLIT in children, including those with perennial allergic rhinitis...
September 21, 2016: Journal of Allergy and Clinical Immunology in Practice
Aaron K Kobernick, A Wesley Burks
Food allergy has grown in rapidly in prevalence, currently affecting 5% of adults and 8% of children. Management strategy is currently limited to 1) food avoidance and 2) carrying and using rescue intramuscular epinephrine/adrenaline and oral antihistamines in the case of accidental ingestion; there is no FDA approved treatment. Recently, oral, sublingual and epicutaneous immunotherapy have been developed as active treatment of food allergy, though none have completed phase 3 study. Efficacy and safety studies of immunotherapy have been variable, though there is clearly signal that immunotherapy will be a viable option to desensitize patients...
October 2016: Allergology International: Official Journal of the Japanese Society of Allergology
Pablo Rodríguez Del Río, Carmen Vidal, Jocelyne Just, Ana I Tabar, Inmaculada Sanchez-Machin, Peter Eberle, Jesus Borja, Petra Bubel, Oliver Pfaar, Pascal Demoly, Moises A Calderón
BACKGROUND: Safety data on "real-life" allergen immunotherapy (AIT) in children and adolescents is usually extrapolated from studies in adults. METHODS: Patients aged 18 or under initiating aeroallergen AIT were evaluated in a prospective European survey. Patient profiles and systemic reactions (SRs) were recorded. Descriptive, univariate and multivariate analyses were used to identify risk factors for SRs. RESULTS: A total of 1,563 patients (mean±SD age: 11...
September 17, 2016: Pediatric Allergy and Immunology
Pascal Demoly, Yoshitaka Okamoto, William H Yang, Philippe Devillier, Karl-Christian Bergmann
INTRODUCTION: The once-daily 300 index of reactivity (IR) house dust mite (HDM) tablet (Actair®; Stallergenes Greer, Antony, France/Shionogi & Co. Ltd., Osaka, Japan) is the first sublingual immunotherapy (SLIT) tablet to be approved for the treatment of HDM-induced allergic rhinitis. AREAS COVERED: This drug profile reviews the current body of evidence on the efficacy, safety and tolerability of the 300 IR HDM tablet, its pharmacodynamics, and its role in clinical practice...
September 15, 2016: Expert Review of Clinical Immunology
Matteo Ferrando, Diego Bagnasco, Giovanni Passalacqua, Gilda Varricchi, Giorgio Walter Canonica
INTRODUCTION: Since its introduction in clinical practice one century ago for the treatment of respiratory allergic diseases, allergen-specific immunotherapy (AIT) has exhibited a relevant clinical efficacy that was subsequently confirmed in controlled trials. Thus, AIT has been accepted worldwide, as testified by guidelines and international documents. AIT is considered pivotal in the management of allergic rhinitis with or without conjunctivitis and with or without asthma. These conditions, in addition to hymenoptera venom allergy, currently are the accepted indications...
September 19, 2016: Expert Opinion on Biological Therapy
Hendrik Nolte, Greg Plunkett, Karin Grosch, Jorgen Nedergaard Larsen, Kaare Lund, Mirko Bollen
BACKGROUND: Consistency in composition and potency, particularly regarding major allergens, is crucial for the quality of extracts for allergen immunotherapy. OBJECTIVE: To characterize the major allergen composition of house dust mite (HDM) extracts commercially available in the United States and the SQ HDM sublingual immunotherapy (SLIT) tablet, and to relate the composition to patient sensitization patterns. METHODS: Der 1/Der 2 ratios were determined in 10,000- and 30,000-AU/mL HDM extracts from 5 US companies and the SQ HDM SLIT-tablet...
September 2016: Annals of Allergy, Asthma & Immunology
J Hahn-Pedersen, M Worm, W Green, J Nørgaard Andreasen, M Taylor
BACKGROUND: Asthma affects an estimated 300 million people worldwide with the condition associated with significant healthcare utilisation costs and a large impact on patient quality of life. The SQ(®) HDM SLIT-tablet (ACARIZAX(®), Hørsholm, Denmark) is a sublingually administered allergy immunotherapy tablet for house dust mite allergic asthma and allergic rhinitis and has recently been licensed in Europe. OBJECTIVE: To assess the cost-effectiveness of ACARIZAX plus pharmacotherapy versus placebo plus pharmacotherapy in patients with house dust mite allergic asthma that is uncontrolled by inhaled corticosteroids, in a German setting...
2016: Clinical and Translational Allergy
Miguel Tortajada-Girbés, Miriam Moreno-Prat, David Ainsa-Laguna, Silvia Mas
BACKGROUND: Spontaneous pneumomediastinum (SPM) is an uncommon disorder. It is rarely reported in paediatric patients and may be accompanied by subcutaneous emphysema. It is usually benign and self-limiting, with only supportive therapy being needed, but severe cases may require invasive measures. Asthma exacerbations have classically been described as a cause of SPM. However, detailed descriptions in asthmatic children are scarce. We aimed at improving the current understanding of the features of SPM and subcutaneous emphysema, and outcomes, by means of a case report and a systematic review...
October 2016: Therapeutic Advances in Respiratory Disease
Yao Yang, Weikang Zhou, Aijun Chen
BACKGROUND: The efficacy of immunotherapy for cedar pollinosis using a single cedar antigen extract via the sublingual route is uncertain. OBJECTIVE: To assess the efficacy of sublingual immunotherapy (SLIT) for patients with cedar pollinosis by performing a systematic review and meta-analysis. METHODS: Randomized clinical trials (RCTs) that compared SLIT with a placebo for patients with cedar pollinosis were searched in the MEDLINE, EMBASE, and Cochrane databases...
October 2016: Annals of Allergy, Asthma & Immunology
Giovanni Passalacqua, Anna Nowak-Węgrzyn, Giorgio Walter Canonica
Sublingual immunotherapy (SLIT) is increasingly used worldwide, and several products have been recently registered as drugs for respiratory allergy by the European Medicine Agency and the Food and Drug Administration. Concerning inhalant allergens, the safety of SLIT is overall superior to that of subcutaneous immunotherapy in terms of systemic adverse events. No fatality has been ever reported, and episodes of anaphylaxis were described only exceptionally. Looking at the historical and recent trials, most (>90%) adverse events are "local" and confined to the site of administration...
August 12, 2016: Journal of Allergy and Clinical Immunology in Practice
Stephen R Durham, Peter S Creticos, Harold S Nelson, Ziliang Li, Amarjot Kaur, Eli O Meltzer, Hendrik Nolte
BACKGROUND: Data comparing the treatment effect of allergy immunotherapy and pharmacotherapy are lacking. OBJECTIVE: We sought to indirectly compare the treatment effect of sublingual immunotherapy (SLIT)-tablets with pharmacotherapy for seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR). METHODS: Pooled data from randomized, double-blind, placebo-controlled trials for the clinical development programs of selected allergic rhinitis treatments were evaluated...
October 2016: Journal of Allergy and Clinical Immunology
Hendrik Nolte, David I Bernstein, Harold S Nelson, Jörg Kleine-Tebbe, Gordon L Sussman, Dorthe Seitzberg, Dorte Rehm, Amarjot Kaur, Ziliang Li, Susan Lu
BACKGROUND: The house dust mite (HDM) sublingual immunotherapy (SLIT) tablet (MK-8237; Merck & Co, Kenilworth, NJ/ALK-Abelló, Hørsholm, Denmark) has demonstrated beneficial effects on allergic rhinoconjunctivitis and asthma outcomes in European trials. OBJECTIVE: This is the first trial to assess the efficacy/safety of HDM SLIT-tablets in North American subjects with HDM-induced allergic rhinitis with or without conjunctivitis (AR/C). METHODS: In this double-blind, multicenter trial (NCT01700192) 1482 subjects (aged ≥12 years) with HDM-induced AR/C with or without asthma were randomized to a daily SQ HDM SLIT-tablet (12 SQ-HDM dose) or placebo for up to approximately 52 weeks...
August 10, 2016: Journal of Allergy and Clinical Immunology
Marie-Luise Lemberg, Peter Eberle, Kija Shah-Hosseini
Background. Nonperception of efficacy ranks among the most commonly cited causes for nonadherence to sublingual immunotherapy (SLIT). Quality of life (QoL) in patients is a determining factor influencing adherence. We investigated QoL and adherence separately in SLIT patients at one pediatric practice in Germany. Methods. We conducted a noninterventional, cross-sectional, retrospective, quality-of-life survey among pediatric patients treated with SLIT. QoL was assessed using the generic SF-12 health survey in German...
2016: BioMed Research International
Monica G Lawrence, John W Steinke, Larry Borish
OBJECTIVE: To discuss the general immunologic changes that occur during immunotherapy, focusing on the differences between subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). DATA SOURCES: PubMed literature review. STUDY SELECTIONS: Articles pertaining to SCIT and SLIT, with specific emphasis on those that included immune mechanistic studies. RESULTS: Both SCIT and SLIT are characterized by the induction of regulatory B and T cells, decreased allergen-specific T-cell proliferation, a shift from a TH2 to TH1 cytokine milieu and from an IgE to an IgG4/IgA antibody response...
August 2016: Annals of Allergy, Asthma & Immunology
Ayfer Yukselen
Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications...
July 2016: Asia Pacific Allergy
Kathrin Damm, Janina Volk, Andreas Horn, Jean-Pierre Allam, Ninette Troensegaard-Petersen, Niels Serup-Hansen, Thomas Winkler, Ivonne Thiessen, Kathrin Borchert, Eike G Wüstenberg, Thomas Mittendorf
BACKGROUND: Allergic Rhinitis (AR) is a common disorder in Europe with Allergic Asthma (AA) as a frequent comorbidity. Allergy immunotherapy (AIT) is the only causal therapy of AR and AA, and can be administered as subcutaneous injections at the physician or as sublingual drops or tablets at home. The usual treatment duration is 3 years. OBJECTIVE: This study aimed to elicit patient preferences to identify the AIT administration mode preferred by patients. METHODS: A discrete-choice-experiment (DCE) was developed to determine how people weight different treatment options using a paper-based questionnaire from June to September 2014, including 16 study centres...
December 2016: Health Economics Review
Y Okamoto, S Fujieda, M Okano, Y Yoshida, S Kakudo, K Masuyama
BACKGROUND: House dust mite (HDM) is the major indoor allergen for allergic diseases such as allergic rhinitis (AR) and asthma. Although sublingual immunotherapy is a curative treatment for HDM-induced AR, data from large-scale studies are limited. We evaluated the efficacy and safety of HDM tablets in adolescent and adult patients (aged 12-64 years) with HDM-induced AR with or without intermittent asthma. METHODS: In a double-blind trial in Japan, 968 subjects were randomized 1 : 1 : 1 to 300 index of reactivity (IR), 500 IR, or placebo groups...
July 29, 2016: Allergy
Amber N Pepper, Moisés A Calderón, Thomas B Casale
Allergen immunotherapy is the only disease-modifying treatment for allergic diseases. Sublingual immunotherapy (SLIT) in liquid and tablet form has been used by clinicians in Europe for years, but has only recently gained popularity and approval in the United States. In 2014, the US Food and Drug Administration approved 3 SLIT tablets for the treatment of allergic rhinitis, with or without allergic conjunctivitis. Immunotherapy treatment strategies for the polysensitized patient vary between the United States and Europe...
July 21, 2016: Journal of Allergy and Clinical Immunology in Practice
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