Allergen immunotherapy as a drug: the new deal of grass allergen tablets from clinical trials to current practice.

Currently, sublingual immunotherapy (SLIT) may be performed by a number of allergen extract in different preparations but in a near future only products fulfilling the requirements from the regulatory agencies, that make mandatory a pharmaceutical quality, will be authorized. Indeed, two products with such characteristics are already available for SLIT in grass pollen allergic patients, Grazax from Alk-Abellò and Oralair from Stallergenes. The data from registrative trials as well as from postmarketing studies provide evidence of efficacy and safety of such products. This articles reviews the similarities and the differences of Grazax and Oralair, both designed as drugs for the treatment of grass pollen allergy with the aim, which is exclusive of allergen immunotherapy, to work on the natural history of allergy and not only on symptoms as rescue medications do. The aim of this paper is to evaluate the available trials with Grazax and Oralair in terms of pre-seasonal schedule approach to support their use in clinical practice. Such kind of treatment makes possible a continuous dialogue between clinical investigators and clinical practitioners, and is the only way for scientific progress that puts the patient's health at the first place.