A novel and well tolerated mite allergoid subcutaneous immunotherapy: evidence of clinical and immunologic efficacy

Abstract

Allergy to house dust mite is one of the most common causes of allergic rhinitis. A novel tyrosine-adsorbed, modified allergen product, Acarovac Plus, developed for the treatment of perennial mite allergy seeks to address the underlying cause of allergic rhinitis in this instance. One of two dosing regimens may be used, either the Conventional Regimen or the Cluster Regimen. We sought to compare the efficacy and safety of a specific immunotherapy, developed for the treatment of perennial mite allergy, administered under a Conventional and Clustered dosing schedule in patients with persistent allergic rhinitis. Thirty adult patients, between 18 and 65 years old, with allergic rhinitis and/or asthma secondary to hypersensitivity to Dermatophagoides pteronyssinus were administered with either conventional or cluster initial regime, with a final visit one week after the last dose administration. The efficacy to the Conventional and Cluster regimens was measured using a Nasal Challenge Test monitoring clinical symptoms and peak nasal inspiratory flow. Total IgE, serum-specific inmunoglobulins (IgE and IgG4) to Dermatophagoides pteronyssinus and relevant cytokines (IFN-γ, IL-4, IL-5, IL-10 and IL-13) were assessed. A Satisfaction Questionnaire (TSQM) was completed after each patient's final visit. The tolerability of the vaccine was assessed monitoring adverse reactions. No adverse events were recorded in either conventional or cluster regime. The specific Nasal Challenge Test led to a decrease in symptom scores and a significant decrease in mean nasal peak inspiratory flow drop was recorded in both dosing regimen groups. A significant increase in IgG4-specific antibody titres was assessed. No significant changes were observed in concentrations of total IgE, specific IgE or cytokines (IFN-γ, IL-4, IL-5, IL-10 and IL-13). Patients declared themselves most satisfied in relation to “Secondary effects”, with high overall satisfaction in both groups. Cluster and conventional specific immunotherapy resulted in no adverse reaction(s) and led to similar improvements in immunological parameters, clinical efficacy (Nasal Challenge Test) and high overall satisfaction.

Randomized Dose–Response Study of Subcutaneous Immunotherapy with a Dermatophagoides pteronyssinus Extract in Patients with Respiratory Allergy

“…The clinical efficacy of another DPT subcutaneous immunotherapy product (DPT allergoid adsorbed to L -tyrosine) was demonstrated using a similar nasal provocation test in patients with allergic rhinitis and/ or asthma secondary to DPT hypersensitivity [25]. The study evaluated two different dosing schedules of DPT extract: a conventional escalating dose regimen over 3 weeks and a cluster schedule (more than 1 dose/visit) over 4 weeks.…”

Specific immunotherapy plus Clostridium butyricum alleviates ulcerative colitis in patients with food allergy

“…Others also observed similar phenomenon. Such as Roger et al treated a group of patients with allergic rhinitis and found that the SIT had no significant effect on concentrations of total IgE, specific IgE or Th2 cytokines, although satisfactory relief of allergic rhinitis symptoms was declared by most patients in the period of the treatment 10 . Glover et al found that no effect of SIT on asthma 11 .…”

The safety of self‐administered allergen immunotherapy during the buildup and maintenance phases

“…European IT practices have traditionally used aluminum adjuvants and more recently other depot adjuvants such as tyrosine for allergoid SCIT . The use of these depot adjuvants results in a slower release of the allergoid and has been associated with fewer SRs . The increased safety associated with this slower release, in principle parallels the use of a slower buildup phase.…”