Results from the 5-year SQ grass SLIT-tablet asthma prevention (GAP) trial in children with grass pollen allergy

Publication date: Available online 6 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Erkka Valovirta, Thomas Houmann Petersen, Teresa Piotrowska, Mette Kongensbjerg Laursen, Jens Strodl Andersen, Helle Frobøse Sørensen, Rabih Klink
BackgroundAllergy immunotherapy targets the immunological cause of allergic rhinoconjunctivitis and allergic asthma and has the potential to alter the natural course of allergic disease.ObjectiveThe primary objective was to investigate the effect of the SQ grass SLIT-tablet compared to placebo on the risk of developing asthma.Methods812 children (5-12 years), with a clinically relevant history of grass pollen allergic rhinoconjunctivitis and no medical history or signs of asthma, were included in the randomised, double-blind, placebo-controlled trial, comprising 3 years treatment and 2 years follow-up.ResultsThere was no difference in time to onset of asthma, defined by pre-specified asthma criteria relying on documented reversible impairment of lung function (primary endpoint). Treatment with the SQ grass SLIT-tablet significantly reduced the risk of experiencing asthma symptoms or using asthma medication at the end of trial (odds ratio=0.66, p<0.036), during the 2-year post treatment follow-up, and during the entire 5-year trial period. Also, grass allergic rhinoconjunctivitis symptoms were 22-30% reduced (p<0.005 for all 5 years). At the end of the trial, the use of allergic rhinoconjunctivitis pharmacotherapy was significantly less (27% relative difference to placebo, p<0.001). Total IgE, grass pollen specific IgE, and skin prick test reactivity to grass pollen were all reduced compared to placebo.ConclusionTreatment with the SQ grass SLIT-tablet reduced the risk of experiencing asthma symptoms and using asthma medication, and had a positive, long-term clinical effect on rhinoconjunctivitis symptoms and medication use but did not show an effect on the time to onset of asthma.

Graphical abstract

Teaser

SQ grass SLIT-tablet treatment prevented asthma symptoms and asthma medication use in children with grass pollen ARC and no pre-existing asthma. This disease-modifying effect persisted after end of treatment.


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