Hans Jürgen Hoffmann

Intralymphatic Immunotherapy improves grass pollen allergic rhinoconjunctivitis: A three-year randomized placebo-controlled trial

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BACKGROUND: Allergic rhinoconjunctivitis is a global health problem. Different Allergen ImmunoTherapy (AIT) regimes are marketed but have low adherence because they are expensive, complex and time consuming. New AIT forms are needed.

OBJECTIVE: In a three-year follow-up double-blinded randomized placebo-controlled trial we aimed to investigate effect of intralymphatic AIT (ILIT).

METHODS: Patients with grass pollen rhinoconjunctivitis were treated with either three ILIT injections and an ILIT booster one year later, three ILIT injection and a placebo booster or three placebo injections and a placebo booster. Primary outcome was improvement in a combined symptom and medication score, cSMS. A novel evaluation tool with a linear regression model of cSMS and grass pollen counts was developed. Secondary outcomes were changes in grass specific immunoglobulins and skin and nasal provocation tests to grass pollen.

RESULTS: 36 patients were included. Log10 transformed cSMS was reduced by 0.30 (95%CI 0.11 - 0.49), p=0.002 equalling 48.5% (95%CI 24.5% - 62%), in the entirethree-year follow-up period, significant only in the first follow-up season but not in the second and third season. The regression model showed a 37%, p<0.001, reduction in cSMS. The booster injection had no additional. Secondary, repeated measures of IgE and IgG4 to grass, showed significant between-group difference and within-group change in the ILIT groups. No change in provocation test was found.

CONCLUSION: Intralymphatic immune therapy gives a substantial reduction in grass pollen allergy symptoms and use of rescue medication, significant in the first season after treatment. A booster injection had no additional effect.

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology
Volume147
Issue3
Pages (from-to)1011-1019
Number of pages9
ISSN0091-6749
DOIs
Publication statusPublished - Mar 2021

Bibliographical note

Copyright © 2020. Published by Elsevier Inc.

    Research areas

  • Allergic rhinoconjunctivitis, allergen immunotherapy, combined symptom medication score, intralymphatic immunotherapy, outcome parameters, ultrasound-guided injections

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