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 Vol. 131; no. 1; pp. 103 - 109.e7
• Main Authors: Patel, Deepen, Couroux, Peter, Hickey, Pascal, Salapatek, Anne Marie, Laidler, Paul, Larché, Mark, Hafner, Roderick P.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.01.2013; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; allergens; 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; burden of disease; cat allergy; Cats; clinical trials; Conjunctivitis, Allergic - immunology; Conjunctivitis, Allergic - therapy; Desensitization, Immunologic - adverse effects; environmental exposure; 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; morbidity; Non tumoral diseases; nose; Otorhinolaryngology. Stomatology; Peptides; Peptides - administration & dosage; Peptides - chemistry; Peptides - immunology; persistence; placebos; Reproductive system; risk factors; 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; United States > US; cat allergy; EEC; AE; allergic rhinoconjunctivitis; T-cell epitope; environmental exposure chamber; immune tolerance; PAD; TEAE; Allergic rhinitis; Fel d 1 peptide immunotherapy; persistence; TRSS; TOSS; TNSS; PTC; Total rhinoconjunctivitis symptom score; Peptide antigen desensitization; Treatment-emergent adverse events; Adverse event; Total nasal symptom score; Total ocular symptom score; Posttreatment challenge; Allergy; Nose disease; Antigenic determinant; Peptides; Rhinitis; Conjunctiva disease; Conjunctivitis; Posology; Randomization; Immunology; Immunotherapy; T-Lymphocyte; ENT disease; Exposure chamber; Fissipedia; Immunopathology; Carnivora; Desensitization; Antigen; Persistence; Eye disease; Vertebrata; Mammalia; Treatment; Animal; Immune tolerance; Cat; Placebo; Environment
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2012.07.028

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. 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. 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. 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. 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.