Fel d 1–derived peptide antigen desensitization shows a persistent treatment effect 1 year after the start of dosing: A randomized, placebo-controlled study

• Published in: Journal of allergy and clinical immunology 2013-01, Vol.131 (1), p.103-109.e7
• Main Authors: Patel, Deepen, MD, Couroux, Peter, MD, Hickey, Pascal, PhD, Salapatek, Anne Marie, PhD, Laidler, Paul, PhD, Larché, Mark, PhD, Hafner, Roderick P., PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Allergens - administration & dosage; Allergens - chemistry; Allergens - immunology; Allergic rhinitis; allergic rhinoconjunctivitis; Allergies; Allergy and Immunology; Amino Acid Sequence; Animals; Antigens; Asthma; Biological and medical sciences; Biological products; cat allergy; Cats; Conjunctivitis, Allergic - immunology; Conjunctivitis, Allergic - therapy; Desensitization, Immunologic - adverse effects; environmental exposure chamber; Fel d 1 peptide immunotherapy; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glycoproteins - chemistry; Glycoproteins - immunology; Humans; immune tolerance; Immunopathology; Male; Medical sciences; Middle Aged; Molecular Sequence Data; Non tumoral diseases; Otorhinolaryngology. Stomatology; Peptides; Peptides - administration & dosage; Peptides - chemistry; Peptides - immunology; persistence; Reproductive system; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; T-cell epitope; Treatment Outcome; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Young Adult
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2012.07.028

Background Allergic rhinoconjunctivitis is an increasingly common source of morbidity, with sensitivity to cats accounting for 10% to 15% of disease burden. Allergy to cats is also a major risk factor for the development of asthma. Objectives We sought to probe the persistence of the treatment effect of a novel Fel d 1–derived peptide antigen desensitization (Cat-PAD) 1 year after the start of treatment in subjects with cat allergy–induced rhinoconjunctivitis after standardized allergen challenge. Methods In a randomized, double-blind, placebo-controlled, parallel-group clinical trial, subjects attended an environmental exposure chamber in which they were exposed to cat allergen before and after treatment with 2 different regimens of Cat-PAD over a 3-month period. Clinical efficacy was assessed as a change in total rhinoconjunctivitis symptom scores 18 to 22 weeks and 50 to 54 weeks after the start of treatment. Results Treatment with Cat-PAD showed greater efficacy with 4 administrations of a 6-nmol dose 4 weeks apart than with 8 administrations of a 3-nmol dose 2 weeks apart. The treatment effect of 6 nmol persisted 1 year after the start of treatment and was significantly different from that of 3 nmol ( P  = .0342) and placebo ( P  = .0104). The treatment effect was apparent on both nasal and ocular symptoms at 1 year. Conclusions A short course of Cat-PAD improves the ocular and nasal components of rhinoconjunctivitis symptoms in subjects with cat allergy, with the treatment effect persisting 1 year after the start of treatment.