Kay A B
Allergy and Clinical Immunology, National Heart & Lung Institute, Imperial College, London, UK.
Drugs Today (Barc). 2007 Dec;43(12):841-8. doi: 10.1358/dot.2007.43.12.1162079.
Grazax is a lyophilisate of an extract of Timothy-grass pollen (Phleum pratense) administered by the sublingual route to induce desensitization (or hyposensitization) to grass pollen in subjects with hay fever. Since allergen avoidance measures are limited in hay fever sufferers, present treatment, at least in the United Kingdom, is almost always by symptomatic medication. The effectiveness of symptomatic treatment in hay fever is variable and depends on patient compliance and the judicious prescribing of antihistamines and anti-inflammatory preparations either alone or in combination. Desensitization (hyposensitization or specific immunotherapy) by subcutaneous injection has been shown to be very efficacious and is used for patients who do not adequately respond to drug treatment. A rare side effect of desensitizing injections is anaphylaxis, and so use is limited to specialized centers. For these reasons there has been considerable interest in specific immunotherapy by the sublingual route. Grazax has recently been approved in the United Kingdom. It is commenced at least four months prior to the expected start of the grass pollen season and in line with injection immunotherapy treatment will be recommended for a period of three years with annual reviews to assess patient outcomes. Grazax grass allergen tablets are well tolerated in patients with grass pollen allergy with most adverse events being mild local reactions. There have been no instances of anaphylaxis. In randomized double-blind placebo controlled trials Grazax reduces symptoms and medication scores in adults with hay fever. The long-term effects of Grazax are currently being investigated.
格拉扎克斯(Grazax)是梯牧草花粉(早熟禾)提取物的冻干制剂,通过舌下途径给药,用于使花粉症患者对草花粉产生脱敏(或减敏)作用。由于花粉症患者避免接触过敏原的措施有限,目前的治疗方法,至少在英国,几乎总是采用对症药物治疗。对症治疗在花粉症中的效果因人而异,取决于患者的依从性以及抗组胺药和抗炎制剂单独或联合使用时的合理处方。皮下注射脱敏(减敏或特异性免疫疗法)已被证明非常有效,用于对药物治疗反应不佳的患者。脱敏注射的一种罕见副作用是过敏反应,因此其使用仅限于专业中心。由于这些原因,舌下途径的特异性免疫疗法引起了人们的极大兴趣。格拉扎克斯最近在英国获得批准。它至少在预计的草花粉季节开始前四个月开始使用,并且与注射免疫疗法一样,建议进行为期三年的治疗,并每年进行复查以评估患者的治疗效果。格拉扎克斯草过敏原片剂在草花粉过敏患者中耐受性良好,大多数不良事件为轻度局部反应。未发生过敏反应。在随机双盲安慰剂对照试验中,格拉扎克斯可降低花粉症成人的症状和药物评分。格拉扎克斯的长期效果目前正在研究中。