Personalized allergy treatment concept with grass pollen transforming into medicine.

Allergy Relief: Is There an Optimal Dose?

Rhea Morgan in Health & Wellness December 2025 • 4 min read.

"Reanalyzing Immunotherapy Data for Personalized Treatment"

Allergic rhinoconjunctivitis, often accompanied by allergic asthma, affects many, leading to reliance on subcutaneous immunotherapy (SCIT). SCIT's effectiveness varies between different allergen immunotherapy (AIT) products, which aren't directly comparable due to differences in allergen content, structure, adjuvants, and formulations. As a result, each product requires individual efficacy documentation.

One such product, Alutard SQ Phleum pratense, used for grass pollen allergy, has demonstrated efficacy in adults and children in controlled clinical trials. These trials tested both the maximum maintenance dose of 100,000 SQ-U and a lower dose of 10,000 SQ-U. These studies highlight Alutard SQ Phleum pratense potential in allergy management.

Now, reanalyzing data from a large UK study (UK22) using a combined symptom and medication score (CSMS), provides new insights. This method, endorsed by the World Allergy Organization (WAO) and the European Academy of Allergy and Clinical Immunology (EAACI), offers a more comprehensive way to assess AIT efficacy by considering both symptom severity and medication use. This approach aims to standardize clinical endpoints in AIT trials, improving their quality and comparability.

Personalized Allergy Treatment: Finding the Right Dose

Personalized allergy treatment concept with grass pollen transforming into medicine.

The reanalysis of the UK22 trial applied the combined symptom and medication score (CSMS) to data from patients receiving either a placebo, 10,000 SQ-U, or 100,000 SQ-U of Alutard SQ Phleum pratense. The CSMS considered nasal, eye, and lung symptoms, along with medication usage weighted by type (e.g., sodium cromoglicate, fluticasone nasal spray).

The results showed that both doses significantly reduced composite combined scores compared to the placebo group. Specifically:

The 100,000 SQ-U group saw a reduction of 2.47 score points (P < .0001), a 36.06% relative difference to placebo.
The 10,000 SQ-U group experienced a reduction of 1.70 score points (P = .0098), a 24.85% relative difference to placebo.
The differences between the two immunotherapy groups were not statistically significant.

These findings suggest that both doses offer clinically relevant improvements, with relative differences in composite combined scores exceeding the 20% threshold recommended by the WAO. However, the higher dose (100,000 SQ-U) was associated with a greater frequency of adverse events. This raises the possibility of tailoring AIT treatment based on individual patient needs.

A Tailored Approach to Allergy Relief

This reanalysis supports the idea of a patient-individualized treatment schedule. Starting with a lower maintenance dose of 10,000 SQ-U, where clinical efficacy has been demonstrated, may be optimal. If symptoms persist during the grass pollen season, the dose could be increased to 100,000 SQ-U to achieve a greater clinical effect.

This approach could strike a balance between tolerability and clinical effectiveness. By carefully adjusting the dose based on individual responses, healthcare providers can potentially optimize outcomes for patients undergoing AIT.

Ultimately, personalized immunotherapy offers the potential to significantly improve the quality of life for individuals struggling with allergic rhinoconjunctivitis, paving the way for more effective and well-tolerated treatment strategies.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jaci.2018.07.034, Alternate LINK

Title: Uk Immunotherapy Study: Reanalysis By A Combined Symptom And Medication Score

Subject: Immunology

Journal: Journal of Allergy and Clinical Immunology

Publisher: Elsevier BV

Authors: Anthony J. Frew, Christian Ljørring, Hendrik Wolf, Eike Wüstenberg, Stephen R. Durham, Christopher J. Corrigan, Richard J. Powell, Oliver Pfaar

Published: 2018-12-01

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Everything You Need To Know

1

What is subcutaneous immunotherapy (SCIT), and why is it relevant to allergy treatment?

Subcutaneous immunotherapy (SCIT) is a type of treatment where allergens are administered through injections. This approach aims to desensitize the body to specific allergens, offering relief from allergic symptoms. In this context, SCIT is a critical method for delivering allergen immunotherapy (AIT) products, which are used to manage allergies like allergic rhinoconjunctivitis and allergic asthma. The effectiveness of SCIT is highlighted in the study by using Alutard SQ Phleum pratense.

2

What is Alutard SQ Phleum pratense, and what role does it play in allergy management?

Alutard SQ Phleum pratense is a specific allergen immunotherapy (AIT) product used to treat grass pollen allergies. It has been tested in clinical trials at different doses, showing its effectiveness in managing symptoms in adults and children. The trials specifically tested a maximum maintenance dose of 100,000 SQ-U and a lower dose of 10,000 SQ-U. The reanalysis of the UK22 study focused on this product, demonstrating its potential in providing relief. The implications suggest that Alutard SQ Phleum pratense can provide a path to manage allergies and highlights the importance of considering different doses for optimal results.

3

What is the combined symptom and medication score (CSMS), and why is it important in evaluating allergy treatments?

The combined symptom and medication score (CSMS) is a method used to assess the effectiveness of allergen immunotherapy (AIT). It evaluates both the severity of allergy symptoms and the use of medications. Endorsed by the World Allergy Organization (WAO) and the European Academy of Allergy and Clinical Immunology (EAACI), CSMS provides a standardized way to measure AIT efficacy, including symptom severity from nasal, eye, and lung. This method improves the quality and comparability of clinical trials by providing a more comprehensive view of treatment outcomes, as seen in the reanalysis of the UK22 study.

4

What were the key findings regarding the different doses of Alutard SQ Phleum pratense?

The study found that both the 10,000 SQ-U and 100,000 SQ-U doses of Alutard SQ Phleum pratense significantly reduced allergy symptoms compared to a placebo. The 100,000 SQ-U dose resulted in a 36.06% relative difference, while the 10,000 SQ-U dose showed a 24.85% relative difference. While both doses were effective, the higher dose (100,000 SQ-U) was associated with more adverse events. This suggests that it might be possible to personalize treatment by starting with a lower dose (10,000 SQ-U) and adjusting it based on the patient's response and tolerability.

5

How can allergy treatment be personalized, according to the study's findings?

Personalized allergy treatment involves tailoring the dose of allergen immunotherapy (AIT) based on an individual's needs, tolerability, and clinical response. The reanalysis of the UK22 study supports this approach. The results suggest starting with a lower dose, like 10,000 SQ-U of Alutard SQ Phleum pratense, and increasing it to 100,000 SQ-U if needed. This approach aims to maximize clinical benefit while minimizing adverse effects. It allows for an individualized treatment plan, improving the management of allergic symptoms.