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In order to compare the safety and the efficacy of two grass pollen extracts made from the same starting material, i.e. equal proportions of cocksfoot and timothy, a 3-year study was made on patients with hay fever. One product was a dialysed aqueous extract of pollens which was chemically conjugated to activated sodium alginate ( Conjuvac ). The other was a pyridine-extracted alum-precipitated crude extract (Allpyral). Forty patients with classical hay fever were admitted to the study. All gave positive result to prick and nasal/conjunctival testing with extracts of both cocksfoot and timothy grass. Thirty-five patients completed all 3 years of the study. Seventeen/eighteen Allpyral-treated and 17/17 Conjuvac -treated patients were subjectively improved. There was no significant difference in symptom scores between the two groups. Challenge tests showed a tendency to reduced sensitivity to allergen in the Conjuvac -treated but not in the Allpyral-treated group. The median values for specific IgG and IgE showed the same pattern of reaction as seen in earlier studies of pollen hyposensitization. There was, however, a greater increase of grass-specific IgG in the Conjuvac -treated patients. No serious adverse effects were seen in any of the treatment groups, but there were slightly fewer side effects in the Conjuvac group.