Out-of-season recollection of drug use for seasonal IgE-mediated rhinitis: useful but an overestimation

Adherence and quality of life in adults and children during 3-years of SLIT treatment with Grazax-a real life study

Respiratory allergic disease represents a global health problem, 30% of the population suffers from allergic rhinoconjunctivitis and 20% suffer from asthma. Allergy immunotherapy induce immunological tolerance and thereby modify the response to allergens and sublingual immunotherapy (SLIT) offers the possibility of home administration of allergen therapy, but adherence is more uncertain. The aim of the study was to investigate the adherence with GRAZAX in adults and children ≥ 5 years during three consecutive years of treatment. This was a non-interventional, prospective, observational, multi-center, open-label study to investigate adherence, quality of life, safety and tolerability of GRAZAX in adult and pediatric patients in a real-life setting. During the 3-years study period estimation of adherence was done regularly. Quality of life as well as symptom score was also assessed. In total, 399 patients (236 adults and 163 children) were included in the study. At baseline, 100% suffered from moderate-severe eyes and nose symptoms, and 31% had asthma in the grass pollen season. Overall, 55% completed a 3-years treatment period, whereas 37% stopped before end of study and 8% were lost to follow up. After 3 years, the adherence rate decreased from 98.2% (first month), 93.7% (first year), 93.2% (second year) and 88.9% (third year) and adverse events were the main reason for pre-term termination. The study suggests a good adherence to treatment in a real life setting among the patients finalizing 3-years SLIT therapy. The treatment was effective both on symptoms and HRQL.

A three-year trial of the allergy immunotherapy GRAZAX shows good adherence and tolerance among adults and children. Respiratory allergic disease is a significant global health burden, with 30 per cent of Europe’s population suffering from hayfever and 20 per cent from allergic asthma. While antihistamines and steroids can treat symptoms successfully, they do not tackle the underlying allergy. Recent progress in immunotherapies such as GRAZAX—a therapy specifically targeting grass pollen allergy—have shown promise. Hampus Kiotseridis at Lund University, Sweden, and co-workers tracked patient adherence and health in 399 adults and children taking GRAZAX over three years. 55 per cent of patients completed the study treatment, with 85 per cent taking GRAZAX six to seven times a week. GRAZAX proved to be well-tolerated overall, effectively tackling symptoms and improving patients’ quality of life.

Grass pollen symptoms interfere with the recollection of birch pollen symptoms - a prospective study of suspected, asymptomatic skin sensitization

BACKGROUND

Asymptomatic skin sensitization (AS) is a risk factor for the development of allergic symptoms. A meticulous definition of this condition requires a systematic assessment of clinical symptoms before inclusion.

OBJECTIVE

To examine the concordance between retrospective assessment of seasonal allergic symptoms and prospective seasonal symptom registration among subjects with AS.

METHODS

On the basis of a population survey, autumn 2002, including skin prick tests (positive if > or =3 mm) and a screening questionnaire, 87 subjects with AS to birch and/or grass pollen, birch and/or grass pollen allergic symptomatic subjects (n = 63) and healthy controls (n = 40) were included in January to March 2003, completed diary cards on symptom and medication use during the relevant seasons 2003, and were examined at follow up in autumn 2003. Allergy: positive SPT and symptoms > or = seven diary days.

RESULTS

Eleven AS subjects (birch: n = 10) subsequently developed allergic symptoms, yet nine admitted, at follow up, to have had symptoms before inclusion, or even denied pollen-related symptoms despite a significant diary. Compared with AS subjects sensitized to grass pollen, AS subjects sensitized to birch pollen had significantly larger skin prick reactions and more often and severe pollen symptoms.

CONCLUSION

In the context of double-sensitization, retrospective symptom assessment is not a reliable method for ensuring that subjects classified, as asymptomatically skin sensitized, are truly, asymptomatic. This matter should be considered in studies on allergy development.