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Demoly P, Leroyer C, Serrano E, Le Maux A, Magnier G, Chartier A. The SQ HDM SLIT-Tablet is safe and well tolerated in patients with House Dust Mite allergic rhinitis with or without asthma: A "real-life" French study. Clin Transl Allergy 2022; 12:e12129. [PMID: 35344293 PMCID: PMC8967264 DOI: 10.1002/clt2.12129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/02/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background The SQ House Dust Mite (HDM) SubLingual ImmunoTherapy (SLIT)‐Tablet (Acarizax) is the only allergen immunotherapy authorized by European regulatory authorities to treat HDM‐induced allergic asthma (AA) that is not well‐controlled by inhaled corticosteroids and associated with mild‐to‐severe HDM allergic rhinitis (AR). The aim of this study was to add evidence on the safety of the SQ HDM SLIT‐Tablet in patients with AR, alone or with AA, under real‐life conditions. Methods This was a French “real‐life”, multicenter, non‐comparative, longitudinal, prospective study. It included patients initiating the SQ HDM SLIT‐Tablet for either persistent moderate‐to‐severe HDM AR or AA not well‐controlled by inhaled corticosteroids and associated with mild‐to‐severe HDM AR. Adverse Events (AEs) were collected at the first intake and throughout the study. Logistic regression was used to compare safety according to asthma control before treatment initiation. Results Between May 09, 2018 and May 29, 2019, 1526 patients were enrolled at 185 sites and 1483 were included in the safety population (SAF). Of them, 33.6% had suspected clinical manifestations of AA. Asthma was uncontrolled for 18.2% of the patients, partially controlled for 27.9% and well‐controlled for 53.8%. Overall, 31.9% of the SAF patients experienced at least one AE. The percentage of patients with AEs was 29.9% among patients with AR alone and 35.9% among those with AA (p = 0.0193). No significant difference was observed in the rate of AE or SAE depending on asthma control at inclusion (2.2% of SAEs reported for patients with uncontrolled asthma, 1.4% for partly controlled and 1.1% for well‐controlled). Conclusions The overall results indicate a good SQ HDM SLIT‐Tablet safety profile consistent with that reported in previous studies, regardless of asthma control.
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Affiliation(s)
- Pascal Demoly
- IDESP, UMR UA11 INSERM-University of Montpellier, Montpellier, France.,Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, University Montpellier, Montpellier, France
| | - Christophe Leroyer
- Clinical Investigation Center, CIC Inserm 1412, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France
| | - Elie Serrano
- Department of ENT and Head and Neck Surgery, Hôpital Larrey, University Hospital of Toulouse, Toulouse, France
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Caimmi D, Demoly P. Recommandations pour la prescription de l’immunothérapie allergénique et le suivi du patient — Questions développées et revue de la littérature. REVUE FRANÇAISE D'ALLERGOLOGIE 2021. [DOI: 10.1016/j.reval.2020.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Quiralte J, Lara MA, Sánchez GV, Monteserín J, Fernández L, Gómez-Fernández MC, Madariaga B, Arilla C, Asturias JA, Begoña L, Martínez A. Tolerability and surrogate efficacy parameters of a polymerized depot mixture pollen extracts without dilutional effect. Immunotherapy 2019; 11:1031-1042. [PMID: 31234665 DOI: 10.2217/imt-2019-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate tolerability of subcutaneous immunotherapy, in a polymerized mixture (Olea europaea/Phleum pratense) depot presentation. Patients & methods: A total of 47 poly-allergic patients received: an abbreviated schedule with three injections at weekly intervals or a cluster schedule with two administrations in 1 day. Both treatments continued with 3 monthly maintenance administrations. Results: Two systemic reactions, (4.3%). One grade 0 and one grade I. No local reactions. Immunoglobulin levels, increased significantly at final visit versus baseline in sIgG and sIgG4; in both schedules and allergens, no significant changes in specific immunoglobulin E levels were detected. Cutaneous reactivity at final visit decreased significantly. Conclusion: Both administration schedules with polymerized mixture of O. europaea/P. pratense, presented an excellent tolerability profile and induced preliminary efficacy changes.
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Affiliation(s)
- Joaquín Quiralte
- Hospital Universitario Virgen del Rocío, Allergology Department, Sevilla, Spain
| | | | | | | | - Luís Fernández
- Hospital de Zafra, Allergology Department, Badajoz, Spain
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Laforest L, Belhassen M, Devouassoux G, Didier A, Letrilliart L, Van Ganse É. [Therapeutic adherence in asthma in France: A general review]. Rev Mal Respir 2017; 34:194-222. [PMID: 28359651 DOI: 10.1016/j.rmr.2016.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 03/08/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Adherence in asthma is a paramount issue of disease management. A general review of the French publications on this topic has been conducted. METHODS Research equations used for bibliographic databases (MEDLINE, Science Direct, Banque de données en santé publique, Cochrane and Cairn.info) comprised the following keywords: "asthma", "therapeutic adherence" and "France". These publications unrelated to asthma, focused on asthma management without exploring adherence, or those conducted in populations without French patients were excluded. RESULTS A total of 82 articles have been selected (36 surveys, 4 randomized trials and 42 reviews/syntheses). Whatever the methodology used and publication year, the inadequate therapeutic adherence in asthma was steadily reported, notably for controllers and the quality of use of inhaled devices. CONCLUSION The present review highlights the sustainability of adherence-related issues in asthma and the need to improve patients' knowledge on asthma and the finality of therapy. It also highlights the need of an improved communication between patients and physicians is also advocated. Further studies with more recent data are desirable to assess changes in disease management of asthma and the impact of potential future corrective interventions.
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Affiliation(s)
- L Laforest
- PELyon (Pharmacoepidemiology Lyon), faculté d'odontologie, 11, rue Guillaume Paradin, 69008 Lyon, France
| | - M Belhassen
- PELyon (Pharmacoepidemiology Lyon), faculté d'odontologie, 11, rue Guillaume Paradin, 69008 Lyon, France
| | - G Devouassoux
- Service de pneumologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 69000, Lyon, France
| | - A Didier
- Pôle des voies respiratoires, hôpital Larrey, CHU de Toulouse, 31000, Toulouse, France
| | - L Letrilliart
- Département de médecine générale, faculté de médecine, université Claude-Bernard Lyon I, 69000, Lyon, France
| | - É Van Ganse
- PELyon (Pharmacoepidemiology Lyon), faculté d'odontologie, 11, rue Guillaume Paradin, 69008 Lyon, France; Service de pneumologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 69000, Lyon, France; HESPER 7425, Health Services and Performance Research, Lyon, France.
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Demoly P, Passalacqua G, Pfaar O, Sastre J, Wahn U. Management of the polyallergic patient with allergy immunotherapy: a practice-based approach. Allergy Asthma Clin Immunol 2016; 12:2. [PMID: 26759555 PMCID: PMC4709898 DOI: 10.1186/s13223-015-0109-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/22/2015] [Indexed: 11/21/2022] Open
Abstract
Background The great majority (60–80 %) of patients consulting specialist physicians for allergic respiratory disease are polysensitized and thus may be potentially clinically polyallergic. However, management approaches to allergen immunotherapy (AIT) in polysensitized and polyallergic patients are not standardized. Methods An international group of clinicians with in-depth expertise in AIT product development, clinical trials and clinical practice met to generate up-to-date, unambiguous, pragmatic guidance on AIT in polysensitized and polyallergic patients. The guidance was developed after reviewing (1) the current stance of regulatory bodies and learned societies, (2) the literature data on single- and multi-AIT and (3) the members’ confirmed clinical experience with polysensitized patients. Results AIT is safe and effective in polysensitized
and polyallergic patients, and should always be based on the identification of one or more clinically relevant allergens (based on the type and severity of symptoms, the duration of induced symptoms, the impact on quality of life and how difficult an allergen is to avoid). Single-AIT is recommended in polyallergic patients in whom one of the relevant allergens is nevertheless clearly responsible for the most intense and/or bothersome symptoms. Parallel 2-allergen immunotherapy or mixed 2-allergen immunotherapy is indicated in polyallergic patients in whom two causal relevant allergens have a marked clinical and QoL impact. In parallel 2-allergen immunotherapy (whether subcutaneous or sublingual), high-quality, standardized, single-allergen formulations must be administered with an interval of 30 min. Mixing of allergen extracts may be considered, as long as (1) the mixture is technically feasible, (2) the mixture is allowed from a regulatory standpoint, (3) the allergen doses are reduced in proportion to the number of components but are still at concentrations with demonstrated efficacy. Conclusions Physicians can prescribe AIT (preferably with high-quality, standardized, single-allergen formulations) with confidence in polysensitized and polyallergic patients by focusing on clinical/QoL relevance and safety.
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Affiliation(s)
- Pascal Demoly
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France ; Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino-IST, University of Genoa, Genoa, Italy
| | - Oliver Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany ; Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Universitatsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Ulrich Wahn
- Department of Paediatric Pulmonology and Immunology, Charité Virchow-Klinikum, Humboldt University, Berlin, Germany
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Current world literature. Curr Opin Allergy Clin Immunol 2013; 13:119-24. [PMID: 23242117 DOI: 10.1097/aci.0b013e32835cb509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Current World Literature. Curr Opin Allergy Clin Immunol 2012; 12:670-5. [DOI: 10.1097/aci.0b013e32835af232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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