title: 5-grass pollen tablets achieve disease control in patients with seasonal allergic rhinitis unresponsive to drugs: a real-life study.
abstract: BACKGROUND
  An important subpopulation in allergic rhinitis is represented by patients with severe form of disease that is not responsive to drug treatment. It has been reported that grass pollen subcutaneous immunotherapy is effective in drug-resistant patients. In a real-life study, we evaluated the efficacy of 5-grass pollen tablets in patients with grass pollen-induced allergic rhinitis not responsive to drug therapy.
  
  
  METHODS
  We carried out this multicenter observational study in adults and adolescents with grass-induced allergic rhinitis not responsive to drug therapy who were treated for a year with 5-grass pollen tablets. Clinical data collected before and after sublingual immunotherapy (SLIT) included Allergic Rhinitis and its Impact on Asthma (ARIA) classification of allergic rhinitis, response to therapy, and patient satisfaction.
  
  
  RESULTS
  Forty-seven patients entered the study. By ARIA classification, three patients had moderate to severe intermittent allergic rhinitis, ten had mild persistent allergic rhinitis, and 34 had moderate to severe persistent allergic rhinitis. There were no cases of mild intermittent allergic rhinitis before SLIT. After SLIT, 33 patients had mild intermittent allergic rhinitis, none had moderate to severe intermittent allergic rhinitis, seven had mild persistent allergic rhinitis, and seven had moderate to severe persistent allergic rhinitis. The mean medication score decreased from 4.2±1.3 before to 2.4±2.0 after SLIT (P<0.01), representing a reduction of 42%. The response to treatment before SLIT was judged as poor by 70% of patients and very poor by 30%. Patient satisfaction was significantly increased after SLIT (P<0.01).
  
  
  CONCLUSIONS
  In real life, most patients with grass pollen-induced allergic rhinitis not responsive to drug treatment can achieve control of the condition with one season of treatment using 5-grass pollen tablets.
authors.affiliation: Allergy and Immunology Department, Niguarda Hospital, Milan, Italy.
authors.forename: Elide Anna
authors.initials: EA
authors.lastname: Pastorello
authors.affiliation: Allergy and Immunology Department, Niguarda Hospital, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Losappio
authors.affiliation: Allergy Department, San Marco General Hospital, Bergamo, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Milani
authors.affiliation: Allergy Department, Treviglio Hospital, Bergamo, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Manzotti
authors.affiliation: Allergy Department, Italian Institute for Auxology, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Fanelli
authors.affiliation: Clinical Allergy and Immunology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Pravettoni
authors.affiliation: Department of Pediatrics, Riuniti Hospital, Bergamo.
authors.forename: Fabio
authors.initials: F
authors.lastname: Agostinis
authors.affiliation: Department of Pediatrics, Legnano Hospital, Milan, Italy.
authors.forename: Alberto Flores
authors.initials: AF
authors.lastname: D'Arcais
authors.affiliation: Medical and Scientific Department, Stallergenes Italy, Milan, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Dell'Albani
authors.affiliation: Regulatory Department, Stallergenes Italy, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Puccinelli
authors.affiliation: Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy.
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Incorvaia
authors.affiliation: Medical and Scientific Department, Stallergenes Italy, Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Frati
keywords: allergen immunotherapy; drug resistance; effectiveness; grass pollen; patient satisfaction; rhinitis