@article{Scadding:2017:10.1001/jama.2016.21040,
author = {Scadding, GW and Calderon, MA and Shamji, MH and Eifan, AO and Penagos, M and Dumitru, F and Sever, ML and Bahnson, HT and Lawson, K and Harris, KM and Plough, AG and Laurienzo, Panza J and Qin, T and Lim, N and Tchao, NK and Togias, A and Durham, SR},
doi = {10.1001/jama.2016.21040},
journal = {Journal of the American Medical Association},
pages = {615--625},
title = {Effect of 2 years of treatment with sublingual grass pollen immunotherapy on nasal response to allergen challenge at three years among patients with moderate to severe seasonal allergic rhinitis: The GRASS randomized clinical trial},
url = {http://dx.doi.org/10.1001/jama.2016.21040},
volume = {317},
year = {2017}
}

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TY  - JOUR
AB  - Importance  Sublingual immunotherapy and subcutaneous immunotherapy are effective in seasonal allergic rhinitis. Three years of continuous treatment with subcutaneous immunotherapy and sublingual immunotherapy has been shown to improve symptoms for at least 2 years following discontinuation of treatment.Objective  To assess whether 2 years of treatment with grass pollen sublingual immunotherapy, compared with placebo, provides improved nasal response to allergen challenge at 3-year follow-up.Design, Setting, and Participants  A randomized double-blind, placebo-controlled, 3–parallel-group study performed in a single academic center, Imperial College London, of adult patients with moderate to severe seasonal allergic rhinitis (interfering with usual daily activities or sleep). First enrollment was March 2011, last follow-up was February 2015.Interventions  Thirty-six participants received 2 years of sublingual immunotherapy (daily tablets containing 15 µg of major allergen Phleum p 5 and monthly placebo injections), 36 received subcutaneous immunotherapy (monthly injections containing 20 µg of Phleum p 5 and daily placebo tablets) and 34 received matched double-placebo. Nasal allergen challenge was performed before treatment, at 1 and 2 years of treatment, and at 3 years (1 year after treatment discontinuation).Main Outcomes and Measures  Total nasal symptom scores (TNSS; range; 0 [best] to 12 [worst]) were recorded between 0 and 10 hours after challenge. The minimum clinically important difference for change in TNSS within an individual is 1.08. The primary outcome was TNSS comparing sublingual immunotherapy vs placebo at year 3. Subcutaneous immunotherapy was included as a positive control. The study was not powered to compare sublingual immunotherapy with subcutaneous immunotherapy.Results  Among 106 randomized participants (mean age, 33.5 years; 34 women [32.1%]), 92 completed the study at 3 years. In the intent-to-treat population, mean TNSS sc
AU  - Scadding,GW
AU  - Calderon,MA
AU  - Shamji,MH
AU  - Eifan,AO
AU  - Penagos,M
AU  - Dumitru,F
AU  - Sever,ML
AU  - Bahnson,HT
AU  - Lawson,K
AU  - Harris,KM
AU  - Plough,AG
AU  - Laurienzo,Panza J
AU  - Qin,T
AU  - Lim,N
AU  - Tchao,NK
AU  - Togias,A
AU  - Durham,SR
DO  - 10.1001/jama.2016.21040
EP  - 625
PY  - 2017///
SN  - 0098-7484
SP  - 615
TI  - Effect of 2 years of treatment with sublingual grass pollen immunotherapy on nasal response to allergen challenge at three years among patients with moderate to severe seasonal allergic rhinitis: The GRASS randomized clinical trial
T2  - Journal of the American Medical Association
UR  - http://dx.doi.org/10.1001/jama.2016.21040
UR  - https://jamanetwork.com/journals/jama/fullarticle/2601501
UR  - http://hdl.handle.net/10044/1/44531
VL  - 317
ER  - 

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