Abstract
The effect of sublingual immunotherapy on quality of life (QoL) was examined in patients with grass pollen-induced rhinoconjunctivitis. Patients (n = 855) were randomised to once-daily grass allergen tablets (2,500; 25,000; or 75,000 SQ-T Phleum pratense extract; GRAZAX®) or placebo. Treatment was initiated 8 weeks before the start of the grass pollen season and continued throughout. If symptoms were present, patients received loratadine or placebo rescue medication. There were three major findings: in patients using loratadine, grass allergen tablets provided QOL benefits over placebo; Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score was 17% (p = 0.006) and 20% (p = 0.020) greater with 75,000 SQ-T tablet than with placebo at first and second seasonal visit, respectively; in patients not using loratadine, grass allergen tablets improved QoL more than placebo; RQLQ score was 21% greater (p = 0.021) with 75,000 SQ-T tablet at second seasonal visit; grass tablets (without loratadine) had a greater effect on QoL than loratadine alone. RQLQ score was 26% (p = 0.014) greater with 75,000 SQ-T tablets than loratadine at second seasonal visit. These data show that sublingual immunotherapy with grass allergen tablets improves QOL in allergic rhinoconjunctivitis, reduces symptoms, and that this effect is greater than rescue antihistamine alone.
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Abbreviations
- SF-36:
-
Medical Outcome Study Short Form Health Survey
- IgE:
-
immunoglobulin E
- FEV1:
-
Forced Expiratory Volume
- RQLQ:
-
Rhinoconjunctivitis Quality of Life Questionnaire
- ANOVA:
-
analysis of variance
- CI:
-
confidence interval
- ITT:
-
intention to treat
- PP:
-
per protocol
References
Dahl R, Andersen PS, Chivato T, Valovirta E, de Monchy J (2004) National prevalence of respiratory allergic disorders. Respir Med 98:398–403
Bauchau V, Durham SR (2004) Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 24:758–764
Bousquet J, Bullinger M, Fayol C, Marquis P, Valentin B, Burtin B (1994) Assessment of quality of life in patients with perennial allergic rhinitis with the French version of the SF-36 Health Status Questionnaire. J Allergy Clin Immunol 94:182–188
Leynaert B, Neukirch C, Liard R, Bousquet J, Neukirch F (2000) Quality of life in allergic rhinitis and asthma: A population-based study of young adults. Am J Respir Crit Care Med 162:1391–1396
Storms WW (2004) Pharmacologic approaches to daytime and nighttime symptoms of allergic rhinitis. J Allergy Clin Immunol 114(Suppl):S146–S153
Stuck BA, Czajkowski J, Hagner AE et al. (2004) Changes in daytime sleepiness, quality of life, and objective sleep patterns in seasonal allergic rhinitis: A controlled clinical trial. J Allergy Clin Immunol 113:663–668
Marshall PS, Colon EA (1993) Effects of allergy season on mood and cognitive function. Ann Allergy 71:251–258
Simons FE (1996) Learning impairment and allergic rhinitis. Allergy Asthma Proc 17:185–189
Majani G, Baiardini I, Giardini A et al. (2001) Health-related quality of life assessment in young adults with seasonal allergic rhinitis. Allergy 56:313–317
Durham SR, Walker SM, Varga EM et al. (1999) Long-term clinical efficacy of grass-pollen immunotherapy. New Engl J Med 341:468–475
Hedlin G, Heilborn H, Lilja G et al. (1995) Long-term follow-up of patients treated with a three-year course of cat or dog immunotherapy. J Allergy Clin Immunol 96:879–885
Jacobsen L, Nuchel Petersen B, Wihl JA, Lowenstein H, Ipsen H (1997) Immunotherapy with partially purified and standardized tree pollen extracts IV Results from long-term (6-year) follow-up. Allergy 52:914–920
Mosbech H, Osterballe O (1988) Does the effect of immunotherapy last after termination of treatment? Follow-up study in patients with grass pollen rhinitis. Allergy 43:523–529
Canonica GW, Passalacqua G (2003) Noninjection routes for immunotherapy. J Allergy Clin Immunol 111:437–448
Passalacqua G, Lombardi C, Canonica GW (2004) Sublingual immunotherapy: An update. Curr Opin Allergy Clin Immunol 4:31–36
Marogna M, Spadolini I, Massolo A, Canonica GW, Passalacqua G (2004) Randomized controlled open label study of specific immunotherapy for respiratory allergy in real life: Clinical efficacy and more. Allergy 59:1205–1210
Wilson DR, Torres LI, Durham SR. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2003; (2): CD002893
Fell WR, Mabry RL, Mabry CS. Quality of life analysis of patients undergoing immunotherapy for allergic rhinitis. Ear Nose Throat J 1997; 76: 528–532, 534–536
Moncayo Coello CV, Rosas Vargas MA, del Rio Navarro BE, Lerma Ortiz L, Velazquez Armenta Y, Sienra Monge JJ (2003) [Quality of life in children with allergic rhinitis before and after being treated with specific immunotherapy (cases and controls)]. Rev Alerg Mex 50:170–175 [Article in Spanish]
Walker SM, Pajno GB, Torres Lima M, Wilson DR, Durham SR (2001) Grass pollen immunotherapy for seasonal rhinitis and asthma: A randomised, controlled trial. J Allergy Clin Immunol 107:87–93
Arikan C, Bahceciler NN, Deniz G et al. (2004) Bacillus Calmette-Guérin-induced interleukin-12 did not additionally improve clinical and immunologic parameters in asthmatic children treated with sublingual immunotherapy. Clin Exp Allergy 34:398–405
Bousquet J, Scheinmann P, Guinnepain MT et al. (1999) Sublingual-swallow immunotherapy (SLIT) in patients with asthma due to house-dust mites: A double-blind, placebo-controlled study. Allergy 54:249–260
Laffer S, Valenta R, Vrtala S et al. (1994) Complementary DNA cloning of the major allergen Phl p I from timothy grass (Phleum pratense); recombinant Phl p I inhibits IgE binding to group I allergens from eight different grass species. J Allergy Clin Immunol 94:689–698
Durham SR, Yang WH, Pedersen MR, Johansen N, Rak S. Sublingual immunotherapy with once-daily grass-allergen tablets: A randomised controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802--9
Juniper EF, Guyatt GH (1991) Development and testing of a new measure of health status for clinical trials involving rhinoconjunctivitis. Clin Exp Allergy 21:77–83
Meltzer EO, Casale TB, Nathan RA, Thompson AK (1999) Once-daily fexofenadine HCl improves quality of life and reduces work and activity impairment in patients with seasonal allergic rhinitis. Ann Allergy Asthma Immunol 83:311–317
Berger WE, Kaiser H, Gawchik SM et al. (2003) Triamcinolone acetonide aqueous nasal spray and fluticasone propionate are equally effective for relief of nasal symptoms in patients with seasonal allergic rhinitis. Otolaryngol Head Neck Surg 129:16–23
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Rak, S., Yang, W.H., Pedersen, M.R. et al. Once-daily sublingual allergen-specific immunotherapy improves quality of life in patients with grass pollen-induced allergic rhinoconjunctivitis: A double-blind, randomised study. Qual Life Res 16, 191–201 (2007). https://doi.org/10.1007/s11136-006-9110-3
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DOI: https://doi.org/10.1007/s11136-006-9110-3