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成人花粉变应性鼻结膜炎患者用 300IR 5 草花粉舌下片间断治疗的疗效。

Post-treatment efficacy of discontinuous treatment with 300IR 5-grass pollen sublingual tablet in adults with grass pollen-induced allergic rhinoconjunctivitis.

机构信息

Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France.

出版信息

Clin Exp Allergy. 2013 May;43(5):568-77. doi: 10.1111/cea.12100.

Abstract

BACKGROUND

Sustained efficacy over three pollen seasons of pre- and co-seasonal treatment with 300IR 5-grass pollen sublingual tablet has been demonstrated in adults with moderate-severe grass pollen-associated allergic rhinoconjunctivitis.

OBJECTIVE

To assess the efficacy of discontinuous treatment with 300IR 5-grass pollen sublingual tablet during the post-treatment pollen season of this long-term study.

METHODS

Adults aged 18-50, sensitized to grass pollen, with a history of allergic rhinoconjunctivitis for more than two pollen seasons, and a retrospective rhinoconjunctivitis total symptom score ≥ 12 (0-18 scale), were randomized to receive 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 three consecutive years. They were followed over the subsequent immunotherapy-free pollen season. Post-treatment efficacy was evaluated using the Average Adjusted Symptom Score (AAdSS, adjusting the Rhinoconjunctivitis Total Symptom Score for rescue medication usage) during the post-treatment pollen period. Secondary endpoints included Average Rhinoconjunctivitis Total Symptom Score (ARTSS), Average Rescue Medication Score (ARMS), overall Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score and safety evaluation. Efficacy variables were analysed using ancova.

RESULTS

Overall, 435 patients contributed to the Year 4 efficacy analyses. The Least-Squares (LS) mean differences (95% confidence interval) in AAdSS between active treatment and Placebo over the fourth pollen period were -1.14 (-2.03; -0.26) (P = 0.0114) and -1.43 (-2.32; -0.53) (P = 0.0019) in the (4M) and (2M) groups, corresponding to -22.9% and -28.5% relative LS mean differences (vs. Placebo) respectively. The active groups also showed statistically significant differences compared to Placebo in ARTSS, ARMS and overall RQLQ score. No safety risk was identified during the post-treatment period.

CONCLUSIONS AND CLINICAL RELEVANCE

Pre- and co-seasonal treatment with 300IR 5-grass pollen sublingual tablet administered discontinuously for three consecutive years is efficacious post-treatment, safe and well tolerated. Benefits of treatment were meaningful to patients.

摘要

背景

在中重度花粉相关过敏性鼻结膜炎患者中,300IR 5 草花粉舌下片进行预季前和同季前治疗,其在三个花粉季节的持续疗效已得到证实。

目的

评估本长期研究中治疗后花粉季节间断使用 300IR 5 草花粉舌下片的疗效。

方法

18-50 岁成人,对草花粉过敏,有两个以上花粉季节的过敏性鼻结膜炎病史,回顾性鼻结膜炎总症状评分≥12(0-18 分),随机分为安慰剂或 300IR 片剂组,每日一次,于花粉季节前 4 个月(4M)或 2 个月(2M)开始,连续三年。他们在随后的无免疫治疗花粉季节进行随访。治疗后采用平均调整症状评分(AAdSS,调整鼻结膜炎总症状评分以评估急救药物使用)评估治疗效果。次要终点包括平均鼻结膜炎总症状评分(ARTSS)、平均急救药物评分(ARMS)、整体鼻结膜炎生活质量问卷(RQLQ)评分和安全性评价。采用协方差分析评估疗效变量。

结果

共有 435 例患者参与了第 4 年的疗效分析。在第 4 个花粉期,活性治疗与安慰剂相比,AAdSS 的最小二乘(LS)均值差异(95%置信区间)分别为-1.14(-2.03;-0.26)(P = 0.0114)和-1.43(-2.32;-0.53)(P = 0.0019),(4M)和(2M)组分别为-22.9%和-28.5%相对 LS 均值差异(与安慰剂相比)。与安慰剂相比,活性治疗组在 ARTSS、ARMS 和整体 RQLQ 评分方面也有统计学显著差异。在治疗后期间未发现安全风险。

结论和临床意义

连续三年预季前和同季前使用 300IR 5 草花粉舌下片进行间断治疗,在治疗后是有效的、安全的且耐受良好。治疗的益处对患者有意义。

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