D1.203 - Prospective study to investigate the symptom profile and medication consumption of patients with seasonal allergic rhinitis/rhinoconjunctivitis who are interested in allergen-specific immunotherapy

Numerous clinical trials of allergen immunotherapy (AIT) for birch, grass and house dust mite allergies have failed. It appears that in more than two-thirds of cases, patients who are interested in AIT do not have the moderate to severe symptoms recommended by the guidelines. Here, we investigated how the severity of allergic symptoms is distributed among representative individuals interested in grass pollen AIT with focus on moderate to severe symptoms, defined as a CSMS of ≥1.5.

This epidemiologic study was planned as a multicentre study in Germany. To be included, patients had to have at least 2 years history of grass pollen allergy and a positive SPT for grass. Allergic and asthma symptoms as well as anti-allergic/asthma medication intake (CSMS [0-6 score points], VAS [ranging from 0 to 100]) regarding allergic and asthma symptoms) were determined using an eDiary (CCC STUDY Diary App) during 30 days of the grass pollen season 2025. All analyses were done descriptively.

In total, 543 patients were screened, and 479 patients were evaluated regarding allergic symptoms and medication need, as well as asthma status (N=172 participants) during the grass pollen season 2025. Of all participants, 63.3% of all participants had a CSMS ≥1.5, representing a moderate to severe allergy. The mean/median CSMS was 2.14/1.88 which was composed equally of the dMS (mean/median: 1.06/0.93) and dSS (mean/median: 1.07/0.94). This is in line with the VAS results: mean/median overall allergy symptoms were 41.8/39.4 on the VAS. Regarding asthma, the mean/median VAS was 49.2/52.6. On average, asthma medication was taken on 4.7 (SD: 9.3) of the 30 documented days.

The predefined threshold of CSMS ≥1.5 proved appropriate for identifying patients with relevant CSMS severity who could potentially benefit from AIT. Two thirds of the participants met this criterium. The results also underline asthma comorbidity, observed in over one third of patient, and a moderate level of symptom severity, reflected by a median CSMS of 1.88 and a mean VAS of 41.8.