RESUMO
BACKGROUND: It is recommended to position pollen monitoring stations on rooftop level to assure a large catchment area and to gain data that are representative for a regional scale. Herein, an investigation of the representativeness of pollen concentrations was performed for 20 pollen types in the pollen seasons 2015-2016 in Vienna for rooftop and ground level and was compared with weather data and for the first time with symptom data. METHODS: The complete data set was analyzed with various statistical methods including Spearmen correlation, ANOVA, Kolmogorov-Smirnov test and logistic regression calculation: Odds ratio and Yule's Q values. Computational intelligence methods, namely Self Organizing Maps (SOMs) were employed that are capable of describing similarities and interdependencies in an effective way taking into account the U-matrix as well. The Random Forest algorithm was selected for modeling symptom data. RESULTS: The investigation of the representativeness of pollen concentrations on rooftop and ground level concerns the progress of the season, the peak occurrences and absolute quantities. Most taxa examined showed similar patterns (e.g. Betula), while others showed differences in pollen concentrations exposure on different heights (e.g. the Poaceae family). Maximum temperature, mean temperature and humidity showed the highest influence among the weather parameters and daily pollen concentrations for the majority of taxa in both traps. CONCLUSION: The rooftop trap was identified as the more adequate one when compared with the local symptom data. Results show that symptom data correlate more with pollen concentrations measured on rooftop than with those measured on ground level.
RESUMO
BACKGROUND: This study compared a rapid home-based up-dosing schedule for sublingual immunotherapy (SLIT) drops containing tree pollen allergens with two previously established schedules. Furthermore, the clinical effect of the SLIT was investigated with respect to patients' first pollen season under treatment. METHODS: In this open-label, prospective, patient-preference, non-interventional study, local and systemic reactions were compared between three up-dosing groups using a SLIT formulation containing birch, alder, and hazel pollen extracts (ORALVAC® Compact Bäume). Clinical improvement after patients' first season under treatment was analysed using symptom scores, ARIA classification, symptom control, and the use of symptomatic medication and was compared with data from the previous, pre-treatment pollen season. As the real-life study design allowed no placebo group, the late-treated patients (co-seasonal) served as a control, and crowd-sourced symptom data from persons with hay fever were used from a free web-based online diary. RESULTS: In 33 study centres in Germany and Austria, 164 patients were included. The treatment was well tolerated, without difference between the groups during the up-dosing phase. At the end of the assessment, 96.1% rated the tolerability of the treatment as good or very good. Local reactions were mostly mild in severity and no serious adverse events occurred. Symptom scores decreased from the 2016 pollen season to the 2017 pollen season. As for the ARIA classification, 79.0% of patients had persistent, moderate-to-severe rhinitis before treatment, but only 18.6% had the same classification after treatment. In all, 62.4% of patients achieved symptom control, and 34.3% of patients required no symptomatic medication after treatment. The rhinoconjunctivitis score was 34.4% lower for pre-seasonal treatment initiation than for the control group. Crowd-sourced symptom load indices showed that the 2016 season caused slightly more symptoms; however, it is assumed that this difference of 0.3-0.5 (score range 0-10) was of less clinical relevance. CONCLUSION: The treatment administered using the rapid home-based up-dosing schedule was safe and well tolerated. Symptom relief and reduction in medication use were observed during the first pollen season with SLIT. TRIAL REGISTRATION NUMBER: NCT03097432 (clinicaltrials.gov).