Double-blind, placebo-controlled immunotherapy with mixed grass-pollen allergoids. III. Efficacy and safety of unfractionated and high-molecular-weight preparations in rhinoconjunctivitis and asthma.
Specific immunotherapy with unmodified formalinized allergoids is effective in grass-pollen allergy, but systemic reactions have been observed. A high-molecular-weight formalinized allergoid (HMW-GOID) was fractionated by gel filtration, retaining molecules of greater than 85,000 daltons in the expectation of improving safety without sacrificing efficacy. HMW-GOID and unfractionated allergoid (GOID) had a similar allergenic activity assessed by RAST inhibition, but the HMW-GOID preparation was 65 times less reactive when it was tested by skin prick test than the GOID preparation. A double-blind, placebo-controlled study was carried out in grass pollen-allergic patients with placebo (14 patients), GOID (15 patients), and HMW-GOID (13 patients). An additional group of 18 patients was treated by a rush schedule with a standardized orchard grass-pollen extract. A similar mean cumulative dose was administered with both allergoids. The fractionated allergoid only elicited minor systemic reactions similar to reactions elicited by placebo, whereas 20% of patients treated by GOID and 5.5% of patients receiving the standardized extract had a severe systemic reaction. For rhinitis, conjunctivitis, and asthma, the HMW-GOID and the standardized extract had a similar efficacy, significantly greater than placebo. GOID was less effective than the other two active treatments but was significantly more effective than placebo treatment for asthma and conjunctivitis.
Bousquet
J
J
Clinique des Maladies Respiratoires, Hopital L'Aiguelongue, Centre Hospitalier Universitaire, Montpellier, France.
Maasch
H J
HJ
Hejjaoui
A
A
Skassa-Brociek
W
W
Wahl
R
R
Dhivert
H
H
Michel
F B
FB
D000293:Adolescent; D000328:Adult; D000080384:Allergoids; D001249:Asthma / Q000628:therapy*; D002648:Child; D002986:Clinical Trials as Topic; D003231:Conjunctivitis / Q000628:therapy*; D004311:Double-Blind Method; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007167:Immunotherapy; D008875:Middle Aged; D008970:Molecular Weight; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use*; D011058:Pollen / Q000276:immunology*; D012220:Rhinitis / Q000628:therapy*; D012882:Skin Tests
D000080384:Allergoids; D007074:Immunoglobulin G; D010936:Plant Extracts