Short-Term Subcutaneous Allergy Immunotherapy and Dupilumab are Well Tolerated in Allergic Rhinitis: A Randomized...

Area of Science:

• Allergy and Immunology
• Pharmacology
• Clinical Trials

Background:

• Subcutaneous immunotherapy (SCIT) is effective for seasonal allergic rhinitis (SAR) but carries risks of systemic reactions.
• Dupilumab targets interleukin-4 and interleukin-13, key drivers of type 2 inflammation.

Purpose of the Study:

• To evaluate the efficacy and safety of combining SCIT with dupilumab versus SCIT alone in SAR patients.
• Assessing the impact on nasal symptom scores and treatment tolerability.

Main Methods:

• Phase 2a, double-blind, placebo-controlled study with 103 adults with grass pollen-induced SAR.
• Patients randomized to SCIT, dupilumab, SCIT+dupilumab, or placebo.
• Primary endpoint: change in total nasal symptom score (TNSS) AUC post-nasal allergen challenge at Week 17.

Main Results:

• SCIT+dupilumab did not significantly improve TNSS AUC compared to SCIT alone (-56.76% vs -52.03%).
• Higher proportion of SCIT+dupilumab patients reached maintenance dose (61.5% vs 46.2%).
• Fewer SCIT+dupilumab patients required rescue treatment (7.7% vs 19.2%) and withdrawals (7.7% vs 30.8%).

Conclusions:

• SCIT+dupilumab may enhance SCIT tolerability in SAR patients.
• No significant incremental reduction in post-allergen challenge nasal symptoms was observed compared to SCIT alone.