Universität zu Köln

Koether, Janina, Mandl, Alicia, Allekotte, Silke, Astvatsatourov, Anatoli, Chwieralski, Janin, Liedtke, Jan-Patrick, Pieper-Fuerst, Ursula, Raskopf, Esther, Shah-Hosseini, Kija ORCID: 0000-0001-9616-6942 and Moesges, Ralph (2018). Early nonreactivity in the conjunctival provocation test predicts beneficial outcome of sublingual immunotherapy. Clin. Transl. Allergy, 8. LONDON: BMC. ISSN 2045-7022

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Abstract

Background: Clinical practice needs a common parameter that can provide an early, reliable estimation of the outcome of sublingual immunotherapy (SLIT) in an upcoming pollen season. We investigated whether the conjunctival provocation test (CPT) can predict the beneficial outcome of SLIT in patients with allergic rhinoconjunctivitis after 4 weeks of treatment. Methods: We conducted two separate prospective, randomized, double-blind, placebo-controlled, multicenter trials. Adults 18-75 years of age received placebo or SLIT tablets containing tree or grass pollen allergoids and underwent CPTs. Participants receiving SLIT were divided into two groups (reactive, nonreactive) according to their CPT reactions after 4 weeks of treatment. These two groups were compared with regard to clinical outcome parameters (total combined score, rhinoconjunctivitis total symptom score, total rescue medication score, well days) assessed during the pollen season for the 14-day (tree) or 30-day (tree/grass) peaks and for the entire 60-day seasons. Participants' global evaluations of therapy after completing treatment were also compared. Results: The tree pollen trial randomized 188 participants; 182 participants were evaluable, 76 of whom received SLIT and were suitable for this post hoc analysis. The grass pollen trial included 90 participants; 82 participants were evaluable, 44 of whom underwent SLIT. Comparing SLIT participants who reacted to the CPT after 4 weeks (tree: 77.6%; grass: 79.5%) with those who ceased to show a reaction (tree: 22.4%; grass: 20.5%) (tree: P = 0.0001; grass: P = 0.003), the total combined score for the 14-day (P= 0.017) and 30-day peaks (P= 0.042) as well as the rhinoconjunctivitis total symptom score assessed for the 14-day peak (P= 0.024) were significantly lower in the nonreactive group of the tree pollen trial. In the grass pollen trial, the nonreactive group rated their SLIT treatment significantly better (P = 0.019). Conclusions: Using clinically meaningful outcome parameters during the pollen season, both trials independently led to similar results when comparing participants' reactions to the CPT 4 weeks after beginning SLIT. These results suggest that CPT allows an early estimation of allergic rhinoconjunctivitis symptoms before an upcoming season. Thus, the CPT can be used as a valuable parameter to predict the beneficial outcome of ongoing SLIT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koether, Janina UNSPECIFIED UNSPECIFIED UNSPECIFIED Mandl, Alicia UNSPECIFIED UNSPECIFIED UNSPECIFIED Allekotte, Silke UNSPECIFIED UNSPECIFIED UNSPECIFIED Astvatsatourov, Anatoli UNSPECIFIED UNSPECIFIED UNSPECIFIED Chwieralski, Janin UNSPECIFIED UNSPECIFIED UNSPECIFIED Liedtke, Jan-Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Pieper-Fuerst, Ursula UNSPECIFIED UNSPECIFIED UNSPECIFIED Raskopf, Esther UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah-Hosseini, Kija UNSPECIFIED orcid.org/0000-0001-9616-6942 UNSPECIFIED Moesges, Ralph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-179955
DOI:	10.1186/s13601-018-0214-y
Journal or Publication Title:	Clin. Transl. Allergy
Volume:	8
Date:	2018
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2045-7022
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ALLERGEN-SPECIFIC IMMUNOTHERAPY; RHINITIS; EFFICACY; TRIAL Multiple languages Allergy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17995