Immunotherapy Benefits for Treating Allergic Rhinitis

Researchers who presented their findings at the American Academy of Allergy, Asthma and Immunology’s annual meeting in February shed new light on the benefits of using immunotherapy to treat allergic rhinitis.

David I. Bernstein, MD, professor of medicine and co-director of the Allergy Fellowship Training Program in the division of immunology, allergy and rheumatology at the University of Cincinnati College of Medicine in Ohio, said his research demonstrated that sublingual immunotherapy (SLIT) tablet therapy can be used effectively in patients who may be allergic to Timothy grass and short ragweed and who also have additional allergic sensitivities.

“The presence of sensitization to other aeroallergens in addition to those pollen allergies being treated does not apparently affect treatment response,” he said. Some participants had conjunctivitis, while others did not.

More than 80% of the patients participating in grass- or ragweed-sublingual tablet studies for treatment of seasonal allergic rhinitis were sensitized to other aeroallergens, including tree pollen and house dust mites. Sensitization was determined by measuring serum specific immunoglobulin E (IgE) to indoor and outdoor aeroallergens. “Studies of the ragweed and grass tablet demonstrated significant efficacy when compared to placebo, despite the very high frequency of participating patients with seasonal allergic rhinitis who were sensitized to multiple allergens other than the one they were treated for,” Dr. Bernstein said.

If clinically indicated, Dr. Bernstein said the new sublingual grass and ragweed tablets can be used with confidence in patients with the other unrelated allergies identified by skin testing or measuring serum specific IgE.

The bottom line is that patients with moderate to severe seasonal allergic rhinitis caused by grass pollen allergy or ragweed allergy who are not controlled adequately with medication can be of¬fered an alternative treatment in the form of sublingual tablet immunotherapy. This can be well suited for patients with severe allergies during the grass and ragweed pollen seasons. It is recommended that patients take tablets on a daily basis beginning 12 to 16 weeks prior to the start of the season and continue through the grass or ragweed seasons. “Patients may prefer this option over allergy injections, which are generally administered on a year-round basis,” Dr. Bernstein said.

Furthermore, Dr. Bernstein said that additional sublingual tablet products, such as medications for house dust mites, are currently under development. “This modality may be particularly attractive to children or individuals who are uncomfortable with receiving regular subcutaneous allergen injections,” he said.

Timothy Grass SLIT Tablets Show Promise

Research by Amarjot Kaur, PhD, executive director of biostatistics and research at Merck Research Laboratories in Kenilworth, N.J., revolved around a post hoc efficacy and safety study of Timothy grass SLIT tablets (Merck’s Grastek) and evaluated study participants with varying pre-treatment levels of specific Timothy grass IgEs.