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New sublingual immunotherapy tablet treats tree pollen allergy

Published online: January 14, 2019

Tree pollen allergy is common across North America and Europe and is often caused by pollen from the birch tree family, which includes birch, alder, hornbeam, hazel, beech, chestnut and oak. Co-sensitization to pollen from within this family is common, extending both the season as well as the geographical area in which allergic symptoms are triggered. Allergy immunotherapy is the practice of treating the underlying cause of the disease by exposing patients to allergen gradually increasing the body’s tolerance. Although recent clinical trials have investigated the effect of birch pollen extract sublingual immunotherapy, clinical effect in the tree pollen season remains yet to be demonstrated.

In a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Biedermann and colleagues report the results of a large phase III clinical trial of a sublingual immunotherapy tablet containing birch pollen extract (SQ tree SLIT-tablet, ALK) for the treatment of allergic rhinoconjunctivitis induced by pollen from the birch tree family. 634 adolescent and adult subjects (12-65 years) with moderate to severe allergic rhinoconjunctivitis despite use of symptom-relieving medication were treated daily with the SQ tree SLIT-tablet or placebo starting 16 weeks before and continuing during the tree pollen season. Subjects scored their symptom and medication use daily during the tree pollen season, which comprised the alder, hazel and birch pollen seasons.

The authors found that treatment with SQ tree SLIT-tablet lead to a statistically significant and clinically relevant improvement in the combined allergic rhinoconjunctivitis symptom and medication score compared to placebo. The effect was manifested through both reduced symptoms and reduced medication use, showing that subjects had fewer symptoms despite using less symptom-relieving medication. These treatment effects were substantial and significant not only during the birch pollen season, but also throughout the entire tree pollen season as well as in the separate alder/hazel season. Treatment was well tolerated. The most common side effects were mild or moderate transient local reactions related to the sublingual administration (e.g. mouth itching and throat irritation) during the first weeks of tablet intake.

The results of this study confirmed that the SQ tree SLIT-tablet with birch pollen extract is highly effective in reducing allergic rhinoconjunctivitis symptoms and medication use throughout the entire tree pollen season, comprising hazel, alder and birch. The results also showed that the SQ tree SLIT-tablet was generally well tolerated, supporting self-administration at home. The new allergy immunotherapy tablet could thus be an attractive treatment option for patients with allergy towards pollen from the birch tree family.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

Graphical Abstract