title: Efficacy of a short course of specific immunotherapy in patients with allergic rhinoconjunctivitis to ragweed pollen.
abstract: BACKGROUND
  Specific immunotherapy acts to modify the underlying cause of allergic rhinoconjunctivitis. Addition of adjuvants, such as monophosphoryl lipid A (MPL), might allow for efficacious and safe treatment with only 4 injections administered preseasonally, which is in contrast to most available schedules requiring long injection courses.
  
  
  OBJECTIVE
  The primary objective was to assess the clinical efficacy of Ragweed MATA MPL (short ragweed pollen allergoid adsorbed to L-Tyrosine + MPL) versus placebo in reducing allergic rhinoconjunctivitis symptoms caused by ragweed pollen in an environmental exposure chamber (EEC) 3 weeks after treatment.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled phase IIb study to evaluate the clinical efficacy and safety of Ragweed MATA MPL compared with placebo by using controlled ragweed pollen exposure in an EEC. Two hundred twenty-eight patients with a history of ragweed allergy and positive skin prick test responses to ragweed were randomized and received 4 weekly injections of active treatment or placebo. Total nasal and nonnasal symptom scores were obtained in the EEC before and after treatment.
  
  
  RESULTS
  Mean improvement in total symptom scores in the Ragweed MATA MPL group was statistically significantly greater than in the placebo group (relative mean improvement of active vs placebo, 48%; P < .05; median improvement, 82%). The majority of adverse events (AEs) experienced by subjects were mild injection-site reactions. No severe systemic AEs or serious AEs occurred during the study.
  
  
  CONCLUSIONS
  This study demonstrated that an ultrashort course of Ragweed MATA MPL is efficacious in reducing allergy symptoms in patients with seasonal allergic rhinitis and that it is well tolerated.
authors.affiliation: Allied Research International, Mississauga, Ontario, Canada. Electronic address: PPatel@inflamaxresearch.com.
authors.forename: Piyush
authors.initials: P
authors.lastname: Patel
authors.affiliation: Allergy Therapeutics, West Sussex, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Holdich
authors.affiliation: Bencard Allergie, Munich, Germany.
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Fischer von Weikersthal-Drachenberg
authors.affiliation: Bencard Allergie, Munich, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Huber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D031164:Ambrosia / Q000276:immunology*; D052179:Antigens, Plant / Q000009:adverse effects*; D002985:Clinical Protocols; D003233:Conjunctivitis, Allergic / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000379:methods*; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000628:therapy*; D008050:Lipid A / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000009:adverse effects* / Q000627:therapeutic use*; D006255:Rhinitis, Allergic, Seasonal / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D008050:Lipid A; D010936:Plant Extracts; C586899:ragweed MATA MPL; C433085:ragweed pollen
keywords: AE; AR; Adverse event; Allergic rhinoconjunctivitis; EEC; Environmental exposure chamber; ITT; Intention to treat; MPL; Monophosphoryl lipid A; PP; Per protocol; RQLQ; Rhinoconjunctivitis Quality of Life Questionnaire; SAR; SIT; SU; Seasonal allergic rhinitis; Specific immunotherapy; Standardized units; TSS; Total symptom score; environmental exposure chamber; ragweed; specific immunotherapy; ultrashort course