Abstract
Background
Procedures for specific immune therapy (SIT) vary widely. We were interested whether a pre-seasonal ultra-rush treatment with depigmented and polymerized allergen extracts is effective and safe in patients with severe SAR.
Methods
31 pts (21 f, 10 m, mean age 39.7 years, range: 17–69 years) with severe SAR and partial asthma attacks (31.3%) during pollen season (mean total IgE level 152 kU/L, range: 5–5113 kU/L; mean Phadia CAP class 3.7 and 3.5 against birch pollen and Bet v1, resp.; mean Phadia CAP class 3.7 and 3.3 against grass pollen and Phl p1,5, resp.) were treated with an ultra-rush schedule receiving the maximum dose of 0.2 plus 0.3 mL of a allergen extract (DepiQuick, Novartis, Germany) on day one, followed by further injecting the maximum dose of 0.5 mL at weekly intervals for 5 weeks. Patients were interviewed by a questionnaire 2 months after the pollen season.
Results
75.8% of patients reported a good or very good effect of SIT with respect to their symptoms during the pollen season after having received only one cycle of ultra-rush SIT; 18.4 did not notice any effect after the first cycle; one patient reported an increase of symptoms. 56.5% of patients did use less anti-allergic medication in comparison with their mean need before SIT; in 18.8% the need of medication was comparable to the year before. In 77.8% of all cases ultra-rush SIT was well tolerated subjectively. Local swelling at the injection site was reported in 25.9% (immediate) and 42.4% (delayed); 4 patients felt a mild discomfort after injection with pruritus, fatigue, or dizziness, respectively. The systemic symptoms disappeared spontaneously without medication.
Conclusions
Even for patients with clinically severe SAR and high specific sensitization against birch or grass pollen the pre-seasonal ultra-rush SIT regimen with depigmented, polymerized allergen extracts showed a good efficacy and tolerability.