A new sublingual tree tablet is currently being developed for the treatment of tree pollen induced allergic rhinoconjunctivitis. Allergic rhinitis is estimated to affect 500 million individuals worldwide and is considered a global health problem. It leads to lower school and work performance. Allergic rhinitis is also a risk factor for asthma development.
Currently allergy shots to trees (subcutaneous immunotherapy) leads to the desensitization of tree pollen. There are no sublingual tree tablets available. There are however sublingual tablets for dust, grass and ragweed currently available.
Allergy drops can also be used by allergists for tree desensitization, however that is an off label use and it is not currently covered by insurance companies.
Exposure to three pollen is prominent across Europe and North America. Tree pollen induced allergic rhinitis is commonly caused by allergens from birch, alder, hornbeam, hazel and oak. Birch pollen sensitization is estimated to be 24% in Europe and 16% in the U.S. The only long term strategy for immunomodulation are allergy shots and sublingual tablets/drops.
The sublingual tree tablet is being developed by ALK-Abello to treat allergies from the birch family. In this phase 3 clinical trial, the aim was to demonstrate the efficacy and safety of the sublingual tree tablet compared to placebo in adolescents and adults with birch pollen induced allergic rhinoconjunctivitis not only during the birch pollen season but also during the tree pollen season, comprising hazel, alder and birch.
Conclusions of the study showed:
- The sublingual tree tablet provided clinically relevant and statistically significant improvements in the combined allergic rhinoconjunctivitis symptom and medication score during the birch season and during the entire tree pollen season comprising hazel, alder and birch.
- Improvement manifested through both reduced symptoms and reduced medication use.
- Treatment was well tolerated with no major safety concerns.
The sublingual tree pollen tablet may be an attractive option for those who are predominantly allergic to birch pollen. A potential issue though may be for the patients who are not only allergic to birch pollen, but other tree pollens that are not related to birch. Unlike grass pollen, many tree pollens do not cross react with each other and patients need to be desensitized to each one individually. The allergy doctor will need to decide whether a patient is the right candidate to start allergy shots for different trees or to just use a sublingual tree tablet for the birch tree only.
There is no current cost or name for the sublingual tree tablet. But like the other sublingual tablets mentioned above, the manufacturer will most likely have coupons and/or rebates for those who are prescribed it. Stay tuned for more information.