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Table 7 Long-term efficacy of sublingual immunotherapy after discontinuation of treatment

From: Sublingual immunotherapy: World Allergy Organization position paper 2013 update

First author publication year [ref] Diagnosis Age (years) Study design n Baseline Allergens Allergen daily dose Treatment duration (years) Years after cessation Years blinded n End of follow-up Main results
OTT 2009 [5] ARC 8–65 RDBPC 213* 5 grass pollens: D. glomerata, P. pratensis, L. perenne, A. odoratum. and P. pratense 300 IR/mL (21 mcg of Phl p 5) 3 1 3 91** In the third season, the median of the combined symptom and medication scores had decreased by -–44.7% in the SLIT group and -14.7% in the placebo group compared with baseline values. Symptom scores were reduced by 39.7% in the SLIT group and 1.51% in the placebo group (P < 0.05).
Reductions in combined scores (P = 0.0508) and symptom scores (P = 0.0144) were observed in the participants treated with SLIT during follow up.
Marogna 2010 [6]2 AR with or without asthma 18-–65 Open, pharmacotherapy controlled trial 78 House dust mite 10,000 RAST units/mL; 3 times per week 3 to 5 10 to 12 None 59 The clinical effects persisted for 7 years for those on SLIT for 3 years and for 8 years for on those on SLIT for 4 or 5 years. New sensitizations occurred in all the control subjects and in up to 25% of those on SLIT.
Durham 2012 [4] ARC with or without asthma 18–65 RDBPC 634* Single grass tablet: Phleum pratense 75,000 SQ-T/2,800 BAU (15 mcg of Phl p 5) 3 2 5 241 The mean rhinoconjunctivitis daily symptom score was reduced by 25% to 36% (P ≤ 0.004) in the SLIT group compared with the placebo group over the 5 grass pollen seasons. The rhinoconjunctivitis DMS was reduced by 20% to 45% (P ≤ 0.022 for seasons 1–4; P = 0.114 for season 5), and the rhinoconjunctivitis combined score was reduced by 27% to 41% (P ≤ 0.003) in favor of active treatment.
The percentage of days with severe symptoms during the peak grass pollen exposure was in all seasons lower in the active group than in the placebo group, with relative differences of 49% to 63% (P ≤ 0.0001). Efficacy was supported by long-lasting significant effects on the allergen-specific antibody response.
Didier 2013 [3] ARC 18–51 RDBPC 633* 5 grasses tablet: D. glomerata, P. pratensis, L. perenne, A. odoratum, and P. pratense 300 IR (25 mcg - group 5 major allergens)† 3 1 3 435 For the year 4 pollen period, significant reductions in the AAdSS LS means were observed for both the 300IR (4M) and 300IR (2M) groups, -22.9% and -28.5% respectively (compared to placebo).
            There was no significant difference between the 2 active treatment groups, and no impact of asthma or sensitization status on the efficacy results.
  1. ARC: Allergic rhinoconjunctivitis; AR: Allergic rhinitis; RDBPC: Randomized, double-blind, placebo-controlled trial; SP: Supralingual; LS: Least-Squares; AAdSS: Average Adjusted Symptom Score; DMS: Daily medication score; IR: Index of Reactivity; SQ-T: Standardized Quality Tablets; BAU: Bioequivalent allergy unit;
  2. *Randomized (n); **Per protocol population; †Placebo or a 300IR tablet daily beginning either 4 months (4M) or 2 months (2M) prior to each pollen season and continuing for its duration for 3 consecutive years.