1 Ultra-Rush Specific Immune Therapy with Depigmented and Polymerized Allergen Extracts is Effective and Safe in Patients With Severe SAR Highly Sensitized against Pollen Allergens

BACKGROUND: Procedures for specific immune therapy (SIT) vary widely. We were interested whether a pre-seasonal ultra-rush treatment with depigmented and polymerized allergen extracts is effective and safe in patients with severe SAR. METHODS: 31 pts (21 f, 10 m, mean age 39.7 years, range: 17–69 years) with severe SAR and partial asthma attacks (31.3%) during pollen season (mean total IgE level 152 kU/L, range: 5–5113 kU/L; mean Phadia CAP class 3.7 and 3.5 against birch pollen and Bet v1, resp.; mean Phadia CAP class 3.7 and 3.3 against grass pollen and Phl p1,5, resp.) were treated with an ultra-rush schedule receiving the maximum dose of 0.2 plus 0.3 mL of a allergen extract (DepiQuick, Novartis, Germany) on day one, followed by further injecting the maximum dose of 0.5 mL at weekly intervals for 5 weeks. Patients were interviewed by a questionnaire 2 months after the pollen season. RESULTS: 75.8% of patients reported a good or very good effect of SIT with respect to their symptoms during the pollen season after having received only one cycle of ultra-rush SIT; 18.4 did not notice any effect after the first cycle; one patient reported an increase of symptoms. 56.5% of patients did use less anti-allergic medication in comparison with their mean need before SIT; in 18.8% the need of medication was comparable to the year before. In 77.8% of all cases ultra-rush SIT was well tolerated subjectively. Local swelling at the injection site was reported in 25.9% (immediate) and 42.4% (delayed); 4 patients felt a mild discomfort after injection with pruritus, fatigue, or dizziness, respectively. The systemic symptoms disappeared spontaneously without medication. CONCLUSIONS: Even for patients with clinically severe SAR and high specific sensitization against birch or grass pollen the pre-seasonal ultra-rush SIT regimen with depigmented, polymerized allergen extracts showed a good efficacy and tolerability.