NEW YORK (Reuters Health) Jun 07 – Subcutaneous immunotherapy (SCIT) is at least as effective as drug therapy in controlling seasonal allergic rhinitis, even in the first season after treatment starts, a new review indicates. Total nasal symptom scores were reduced with SCIT by 34.7% compared to placebo, by 31.7% with mometasone versus placebo, and by 6.3% with montelukast versus placebo, the researchers report.

Writing in the Journal of Allergy and Clinical Immunology online May 27, Dr. Paolo M. Matricardi, with Charite Medical University in Berlin, Germany and colleagues point out that subcutaneous immunotherapy is generally regarded as slow-acting and a second-line option if pharmacotherapy isn’t effective or tolerated. However, they wondered if that “slow acting” reputation was really deserved.

In reviewing the published evidence, the authors found only four head-to-head comparison trials, so they also included placebo controlled trials of SCIT and of antihistamines, nasal corticosteroids, or leukotriene antagonists. In all, 42 trials that measured total nasal symptom scores or total symptom scores during the first pollen season after starting treatment were included. Total symptom scores were reduced by 32.9% with SCIT and by 12.0% with desloratadine, relative to placebo.

“We can conclude that SCIT has not only a disease-modifying and long-term effect… but also has a rather powerful non symptomatic effect starting as early as the first season after treatment onset,” Dr. Matricardi and colleagues write. They add, “Our results support the novel concept that cost/benefit analysis of specific immunotherapy in patients with SAR (seasonal allergic rhinitis) should take into account not only its long-term efficacy but also its short-term effect on symptoms.”

Dr. Kenneth Backman of Allergy & Asthma Care of Fairfield County comments: “We have long known that while we counsel patients that it may take 1 to 2 years to see good effect, some patients will see benefits from allergen immunotherapy much sooner. This study confirms that rapid effects can be seen. Even better results are seen after several seasons on injections.”

SOURCE: http://bit.ly/mJmors ;J Allergy Clin Immunol 2011.