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Kleine-Tebbe J, Kretschmar G, Herold A, et al. Safety and tolerability of escalating doses of microencapsulated grass (Phleum pratense) pollen extract (MGPE) for oral immunotherapy (OIT) in grass pollen subjects. J Allergy Clin Immunol 2008; 121:S128. An abstract comparing the initiation of daily SLIT with a 7-week build-up of doubling dose each week to a maximum of 64000 BAU versus 1 week of treatment of 32 000 BAU without a build-up. Adverse reactions were mild and similar between groups and compared to placebo.
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Demoly P, Meziane L, LeGall M, et al. Safety and tolerability of house dust mite tablets in sublingual immunotherapy. J Allergy Clin Immunol 2008; 121:S128. An abstract of dust mite SLIT over 10 days in 31 patients comparing initiation schedules. Mild reactions occurred in both groups starting at 300 IR or building up to 500 IR. In the group starting at 500 IR, severe local adverse events were noted.
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An optimal dose finding study of 628 adults. Adverse reactions were similar for each of the three doses, affecting 64-69% of patients. No serious systemic events or anaphylaxis occurred during the 6-month study period
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Dahl R, Kapp A, Colombo G, et al. Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years. J Allergy Clin Immunol 2008; 121:512-518. An interim analysis focusing on the second year of treatment from a multicenter study of 351 patients receiving SLIT daily for 22 months. Unlike the first year of SLIT treatment, there was not a predominance of local reactions in the actively treated group.
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This was not only the first case report of SLIT-induced anaphylaxis in Europe, it was also unique for the use of a multiallergen extract, containing dust mite and pollens. More studies are necessary to determine if the less common use of multiple allergens will have a poorer safety profile
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Eifan AO, Keles S, Bahceciler NN, Barlan IB. Anaphylaxis to multiple pollen allergen sublingual immunotherapy. Allergy 2007; 62:567-568. This was not only the first case report of SLIT-induced anaphylaxis in Europe, it was also unique for the use of a multiallergen extract, containing dust mite and pollens. More studies are necessary to determine if the less common use of multiple allergens will have a poorer safety profile.
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This case report of SLIT-induced anaphylaxis occurred in the third year of treatment and was notable for the potential of self-administration errors. The patient had missed 3 weeks of dosing and then took 6 times her normal dose leading to the near-fatal reaction
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25
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A 3-month study addressing the difference in safety of single allergen versus multiple allergen SLIT in 159 patients. In this short study, the adverse events related to SLIT were the same in the two groups
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This was a safety study in grass allergic children taking Grazax for 28 days out of season. Adverse reactions led to two out of 45 patients withdrawing from the study
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Ibanez MD, Kaiser F, Knecht R, et al. Safety of specific sublingual immunotherapy with SQ standardized grass allergen tablets in children. Pediatr Allergy Immunol 2007; 18:516-522. This was a safety study in grass allergic children taking Grazax for 28 days out of season. Adverse reactions led to two out of 45 patients withdrawing from the study.
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Pham-Thi N, Scheinmann P, Fadel R, et al. Assessment of sublingual immunotherapy efficacy in children with house dust mite-induced allergic asthma optimally controlled by pharmacologic treatment and mite-avoidance measures. Pediatr Allergy Immunol 2007; 18:47-57. Unlike studies of rhinitis patients with or without asthma, this study enrolled 115 asthmatic children allergic to dust mites. There was no clinical benefit of 18 months of SLIT therapy.
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Pham-Thi N, Scheinmann P, Fadel R, et al. Assessment of sublingual immunotherapy efficacy in children with house dust mite-induced allergic asthma optimally controlled by pharmacologic treatment and mite-avoidance measures. Pediatr Allergy Immunol 2007; 18:47-57. Unlike studies of rhinitis patients with or without asthma, this study enrolled 115 asthmatic children allergic to dust mites. There was no clinical benefit of 18 months of SLIT therapy.
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31
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34250836330
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This study assessed dust mite SLIT for 18 months in 56 children with atopic dermatitis. Adverse events were sparsely reported, but two of the 28 on active SLIT were withdrawn due to generalized itching within an hour of dosing
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Pajno GB, Caminiti L, Vita D, et al. Sublingual immunotherapy in mite-sensitized children with atopic dermatitis: a randomized, double-blind, placebo-controlled study. J Allergy Clin Immunol 2007; 120:164-170. This study assessed dust mite SLIT for 18 months in 56 children with atopic dermatitis. Adverse events were sparsely reported, but two of the 28 on active SLIT were withdrawn due to generalized itching within an hour of dosing.
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Roder E, Berger MY, Hop WCJ, et al. Sublingual immunotherapy with grass pollen is not effective in symptomatic youngsters in primary care. J Allergy Clin Immunol 2007; 119:892-898. SLIT was offered to 168 grass allergic rhinoconjunctivitis patients in the primary care setting. There was no clinical benefit in the active versus the placebo group.
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Roder E, Berger MY, Hop WCJ, et al. Sublingual immunotherapy with grass pollen is not effective in symptomatic youngsters in primary care. J Allergy Clin Immunol 2007; 119:892-898. SLIT was offered to 168 grass allergic rhinoconjunctivitis patients in the primary care setting. There was no clinical benefit in the active versus the placebo group.
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33
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56749131407
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35
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33947408405
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Thirty-five patients with latex sensitivity resulting in urticaria or asthma were treated for 1 year with latex SLIT. Three of the 18 in the active group had itching, burning or swelling of the lips during the build-up phase, regressing spontaneously with ongoing dosing
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Nettis E, Colanardi MC, Soccio AL, et al. Double-blind, placebo-controlled study of sublingual immunotherapy in patients with latex-induced urticaria: a 12-month study. British J Dermatol 2007; 156:674-681. Thirty-five patients with latex sensitivity resulting in urticaria or asthma were treated for 1 year with latex SLIT. Three of the 18 in the active group had itching, burning or swelling of the lips during the build-up phase, regressing spontaneously with ongoing dosing.
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Nettis, E.1
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40
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46049105300
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The use of SLIT is extended in this study to patients experiencing large local reactions to honeybee stings. With clinical efficacy and minimal adverse reactions, the next step will be to study honeybee SLIT for the indicated purpose of treating sting-induced anaphylaxis
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Severino MG, Cortellini G, Bonadonna P, et al. Sublingual immunotherapy for large local reactions caused by honeybee sting: a double-blind, placebo-controlled trial. J Allergy Clin Immunol 2008; 122:44-48. The use of SLIT is extended in this study to patients experiencing large local reactions to honeybee stings. With clinical efficacy and minimal adverse reactions, the next step will be to study honeybee SLIT for the indicated purpose of treating sting-induced anaphylaxis.
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34548164520
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Cox L, Li JT, Nelson H, Lockey R. Allergen immunotherapy: a practice parameter second update. J Allergy Clin Immunol 2007; 120:S25-S85. An extensive update to 2003 parameter put out by the Joint Task Force on practice parameters reviewing and offering recommendations on all aspects of specific immunotherapy.
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Cox L, Li JT, Nelson H, Lockey R. Allergen immunotherapy: a practice parameter second update. J Allergy Clin Immunol 2007; 120:S25-S85. An extensive update to 2003 parameter put out by the Joint Task Force on practice parameters reviewing and offering recommendations on all aspects of specific immunotherapy.
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Canonica GW, Baena-Cagnani CE, Bousquet J, et al. Recommendations for standardization of clinical trials with allergen specific immunotherapy for respiratory allergy. A statement of a World Allergy Organization (WAO) taskforce. Allergy 2007; 62:317-324. Expert task force presents recommendations for study design, patient selection and outcome measures to use in clinical trials of specific immunotherapy.
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Alvarez-Cuesta E, Bousquet J, Canonica GW, et al. Standards for practical allergen-specific immunotherapy. Allergy 2006; 61 ((Supp 82)):1-20.
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44
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33846938383
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Passalacqua G, Musarra A, Pecora S, et al. Quantitative assessment of the compliance with once-daily sublingual immunotherapy in children (EASY Project: evaluation of a novel SLIT formulation during a year). Pediatr Allergy Immunol 2007; 18:58-62. An Italian study of compliance at 3 and 6 months in 71 children on daily SLIT from a unit dose container. By counting containers, compliance was assessed. At 3 months, nine patients had more than 75% compliance and two of them had discontinued.
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Passalacqua G, Musarra A, Pecora S, et al. Quantitative assessment of the compliance with once-daily sublingual immunotherapy in children (EASY Project: evaluation of a novel SLIT formulation during a year). Pediatr Allergy Immunol 2007; 18:58-62. An Italian study of compliance at 3 and 6 months in 71 children on daily SLIT from a unit dose container. By counting containers, compliance was assessed. At 3 months, nine patients had more than 75% compliance and two of them had discontinued.
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45
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29544443510
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Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis
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Casale TB, Busse WW, Kline JN, et al. Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J Allergy Clin Immunol 2006; 117:134-140.
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Casale, T.B.1
Busse, W.W.2
Kline, J.N.3
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