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BACKGROUND: Five-grass pollen tablet is an effective and well-tolerated therapy for patients with allergic rhinoconjunctivitis (ARC). This trial sought to determine the satisfaction and health-related quality of life (HRQoL) of patients undergoing this treatment. METHODS: This was a cross-sectional, multicentre, observational, naturalistic study, following a discontinuous pre- and co-seasonal five-grass pollen regimen over two seasons in Spain (2012, 2013). The HRQoL of the patients was measured with the specific Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) for adults, adolescent (AdolRQLQ), or paediatric (PRQLQ) patients. Treatment satisfaction was assessed by the Satisfaction Scale for Patients Receiving Allergen Immunotherapy (ESPIA) questionnaire. Patients/investigators were surveyed on beliefs and attitudes towards the five-grass pollen tablet. ARC evolution according to allergic rhinitis and its impact on asthma (ARIA) criteria and treatment adherence were evaluated. RESULTS: Among the 591 ARC patients included, the mean (SD) HRQoL scores were 1.40 (1.1) in adults, 1.33 (1.1) in adolescents, and 1.15 (1.1) in children, indicating low levels of impairment (scale 0-6). ESPIA answers showed high levels of satisfaction, with an average score of 69.2 (scale 0-100). According to ARIA criteria, 88.2% of patients reported improvement of ARC. Moreover, this was accompanied by a reduced use of symptomatic medication. Adherence to treatment was estimated at 96.8%. In general, both patients and specialists exhibited a positive attitude towards five-grass pollen tablet treatment. CONCLUSION: ARC patients treated with five-grass pollen tablet showed favourable levels of HRQoL and treatment satisfaction, with concomitant improvements in ARC and symptomatic medication use, which translated into high levels of treatment adherence and a positive attitude towards five-grass pollen tablet.
RESUMEN
BACKGROUND: Subcutaneous immunotherapy is an etiological therapy for certain IgE-mediated diseases. It is usually administered in 2 phases: induction and maintenance. Administration in clustered schedules during the induction phase may be a valid alternative to reach the maintenance dose early if the treatment is well tolerated. OBJECTIVES: To compare the tolerability of different clustered schedules in subcutaneous immunotherapy with standardized allergen extracts administered and to identify factors associated with increased risk of systemic reactions (SRs). METHODS: Retrospective, observational, multicenter study in patients with allergic respiratory disease. RESULTS: Data from 1,147 patients were collected. Thirty-nine patients (3.4%) experienced 42 SRs (0.6% of doses). According to the European Academy of Allergy and Clinical Immunology SR grading system, there were 7 grade 0 reactions (16.7%), 26 grade 1 reactions (61.9%), 8 grade 2 reactions (19.0%), and 1 grade 3 reaction (2.4%). There were no grade 4 SRs (anaphylactic shock). We observed a higher risk of SRs in patients who received an initial dose higher than 0.3 index of reactivity (IR); only 2 reactions occurred after administration of the initial dose of the regimen, both with 0.4 IR. The remainder appeared in subsequent injections, although never with a dose lower than 0.35 IR. CONCLUSIONS: Clustered regimens with IR-standardized extracts are an alternative to classic immunotherapy thanks to their low incidence of SRs compared with other rapid regimens during the induction phase. The ideal clustered regimen should start at an initial dose no greater than 0.35 IR to minimize the incidence of SRs.