Pre-Coseasonal Treatment with a 5-Grass Pollen Sublingual Tablet in Adults Demonstrated a Reduction on Asthma Symptoms in Réunion Island.

BACKGROUND: Asthma is a heterogeneous disease, not only in its clinical expression and course but also in its response to treatment. Most patients are clinically stable with current therapies, while a substantial part of the asthma population develops exacerbation during grass pollen season.

The purpose of this study is to document the impact of a grass allergy immunotherapy tablet (AIT) on the symptom severity in patients with severe allergic rhinitis (SAR) and persistent allergic asthma (PAA).

METHOD: This study included 22 adults, aged 20-45 yrs, with PAA and SAR who met the following inclusion: ≥ two severe asthma exacerbations requiring oral corticosteroids while receiving high dose ICS (≥ 1600 ug BECLOMETHAZONE daily or equivalent), additional controller medications (long acting B2 agonist) during one year prior to screening. Patients were examined at baseline and received a tablet 300IR (GRAZAX^® ALK or ORALAIR^® Stallergènes SA) approximately 2 months before the expected start of the grass pollen season in Réunion Island and then throughout the season between November 2013/April 2014 and November 2014/April 2015.

RESULTS: AIT significantly reduced scores from baseline in ocular and nasal symptoms. Reductions were also seen in the asthmatic scores: improvement of FEV₁ (p<0.05 of predicted values) and breathlessness scores (p=0.0002). The asthma quality-of-life (AQLQ) questionnaire scores improved from baseline after AIT: p=0.003.  At the final visit only 24% had daily activity impairment and 34% had some sleep impairment.

CONCLUSION : The Pre-Coseasonal treatment with 5-grass AIT showed effective symptom control in severe persistent allergic asthma. Symptoms of comorbidities such as rhinitis and conjunctivitis were decreased.