Drug and Therapeutics Bulletin 2008;46:9-10; doi:10.1136/dtb.2008.01.0001
Copyright © 2008 by the BMJ Publishing Group Ltd.

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Grazax for hay fever?

Relevant BNF section: BNF 3.4.2

Over 1 in 5 adults in the UK are estimated to have allergic rhinitis and around half of these people are allergic to grass pollen.¹ Despite optimal use of intranasal corticosteroids and oral antihistamines, some patients continue to have troublesome symptoms. For example, in one general practice survey, 62% of patients taking both these treatments described control of their symptoms as partial or poor.² UK professional guidelines recommend the use of allergen injection immunotherapy in patients with IgE-mediated seasonal pollen-induced rhinitis and/or conjunctivitis "whose symptoms respond inadequately to usual therapy".³ Such intervention by subcutaneous injection aims to modify the underlying cause of allergic rhinitis and can reduce symptoms, but may result in severe bronchospasm and anaphylaxis requiring resuscitation.^4,5 Sublingual immunotherapy has been proposed as an alternative to the subcutaneous route.² Grazax (ALK-Abelló) is the first product licensed in the UK for sublingual immunotherapy. Here we consider its role in the management of patients with hay fever.

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				A. J. Frew Sublingual Immunotherapy N. Engl. J. Med., May 22, 2008; 358(21): 2259 - 2264. [Full Text] [PDF]