Safety and Effectiveness of a Single Multiallergen Subcutaneous Immunotherapy in Polyallergic Patients

Abstract

<b><i>Background:</i></b> As the number of allergic sensitizations increases the severity of allergic respiratory diseases worsens. Multiple monoallergen immunotherapy can be accompanied by poor treatment adherence and high costs, single multiallergen immunotherapy needs to prove efficacy whilst maintaining a good safety profile. <b><i>Methods:</i></b> Observational, retrospective, multicenter study using a 2-pollen single undiluted multiallergen subcutaneous immunotherapy (SCIT) in routine clinical practice in Spain. Patients with rhinoconjunctivitis, with/without controlled asthma, sensitized to grass, olive, Parietaria, Cupressus, plane tree and/or Salsola pollen were included. Primary and secondary clinical efficacy endpoints were quality of life (mini Rhinitis Quality of Life Questionnaire (miniRQLQ)) and visual analogue scale (VAS) respectively. All adverse events were documented. <b><i>Results:</i></b> Ten centers included 97 patients, median age 32 years. SCIT treatment included combinations of grass mix with olive, Parietaria, Cupressus, plane tree or Salsola or olive with Parietaria, Cupressus or Salsola. The mean duration of SCIT was 1.8 years with a high treatment adherence (73%). Significant improvement in quality of life, nasal and ocular symptoms, activity limitations and practical problems (<i>p</i>< 0.0001) and other symptoms (<i>p</i>= 0.024) was observed. Most patients did not develop asthma-like symptoms and a significant improvement of all allergic symptom severity was perceived. VAS showed a significant improvement in rhinoconjunctivitis and asthma by patients and physicians. Twenty-nine patients experienced adverse reactions, 25 had local and 6 had systemic reactions. <b><i>Conclusions:</i></b> Single undiluted multiallergen SCIT treatment of two different pollens is efficacious and safe in both children and adults, showing that it is a suitable option for the treatment of polyallergic patients.

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

“…These trials demonstrated significant improvement in patients who received mixtures of multiple, unrelated allergen extracts, but these studies were done prior to better standardization of extracts 2773–2776 . More recent studies based in Spain have also supported multi‐allergen immunotherapy 2777,2778 . A systematic review in 2009 evaluated 13 multi‐allergen immunotherapy studies (11 SCIT, one SLIT, and one both) and corroborated that co‐administration of two extracts is in fact clinically effective 2779 .…”