Is SLIT-Tablet Tx Safe for Asthma Patients with Allergic Rhinitis?
the MPR take:
Grass pollens are among the most common season aeroallergens that provoke allergic rhinitis with or without conjunctivitis (AR/C) and asthma and AR/C are closely associated. However, patients with asthma may be more susceptible to adverse drug events (ADEs) with sublingual immunotherapy tablet (SLIT-tablet) treatment. A review in the journal Allergy pooled data from eight randomized multicenter double-blind placebo-controlled clinical trials on Timothy grass SLIT-tablet that each lasted approximately 24 weeks, except for one trial that included three years of treatment and two years of post-treatment follow-up. All subjects had a confirmed diagnosis of grass-pollen-induced AR/C with or without controlled asthma and a history of medication use to treat symptoms of AR/C during the previous pollen season. A total of 3,314 adult patients and 881 pediatric patients were included in the pooled analysis, in which 25% of adult grass SLIT-tablet participants, 23% of adult placebo subjects, and 31% of pediatric participants in both groups reported a history of asthma. No increase in systemic allergic reactions or severe allergic swellings were reported in the subjects with reported well-controlled, mild asthma and there was no indication that treatment with grass SLIT-tablet led to acute worsening of asthma, acute asthma attacks, or exacerbations in patients with reported controlled asthma. Two of the studies also reported a significant reduction in asthma symptoms during the grass pollen season for the active treatment group vs. placebo, which may indicate that grass SLIT-tablet treatment is more associated with improvement of symptoms than with increasing the risk of asthma during the pollen season. Large-scale post-marketing surveillance is necessary to provide more conclusive evidence of the safety of grass SLIT-tablet in patients with asthma, the authors report, but these results suggest that it is safe to administer to children and adults with mild, controlled asthma.
Background Patients with asthma may be more susceptible to adverse events (AEs) with sublingual immunotherapy tablet (SLIT-tablet) treatment, such as severe systemic reactions and asthma-related events. Using data from 8 trials of grass SLIT-tablet in subjects with allergic rhinitis with/without conjunctivitis (AR/C), AE frequencies were determined in adults and children with and without reported asthma.
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