Background: The allergists´ tool box in cat allergy management is limited. Clinical studies have shown that holo beta‐lactoglobulin (holoBLG) can restore micronutritional deficits in atopic immune cells and alleviate allergic symptoms in a completely allergen‐nonspecific manner. With this study, we aimed to provide proof of principle in cat allergy.Methods: A novel challenge protocol for cat allergy in a standardized ECARF allergen exposure chamber (AEC) was developed. In an open pilot study (NCT05455749), patients with clinically relevant cat allergy were provoked with cat allergen for 120 min in the AEC before and after a 3‐month intervention phase (holoBLG lozenge 2x daily). Nasal, conjunctival, bronchial, and pruritus symptoms were scored every 10 min– constituting the total symptom score (TSS). Peak nasal inspiratory flow (PNIF) was measured every 30 min. In addition, a titrated nasal provocation test (NPT) was performed before and after the intervention. Primary endpoint was change in TSS at the end of final exposure compared to baseline. Secondary endpoints included changes in PNIF, NPT, and occurrence of late reactions up to 24 h after exposure.Results: 35 patients (mean age: 40 years) completed the study. Compared to baseline, holoBLG supplementation resulted in significant improvement in median TSS of 50% (p < 0.001), as well as in median nasal flow by 20 L/min (p = 0.0035). 20% of patients reported late reactions after baseline exposure, but 0% after the final exposure.Conclusions: Cat allergic patients profited from targeted micronutrition with the holoBLG lozenge. As previously seen in other allergies, holoBLG supplementation also induced immune resilience in cat allergies, resulting in significant symptom amelioration.

Allergen Immunotherapy (AIT) is an effective treatment for patients with pollen, house dust mite, or venom allergy, but treatment adherence can be challenging. Patient preferences play a crucial role in acceptance and adherence to AIT, but little is known about these preferences. This study aimed to understand patient preferences for AIT and how these preferences influence treatment acceptance. A conjoint analysis was conducted among 750 participants from 7 European countries who were allergic to pollen (n = 700) or Hymenoptera venom (n = 50) and had not previously received AIT. Participants were asked to choose between hypothetical AIT products with different attributes, including product type, initial up-dosing posology, potential future risks, and side effects. The relative importance of each attribute was calculated, and sensitivity analyses were performed to assess the impact of specific attribute levels on patient preference. Potential future risk is the attribute with the strongest impact on the importance score for patient preference in both pollen (44%) and venom (41%) allergic patients, followed by side effects (24% for pollen and 35% for venom allergy). Product type was less important, with a 22% importance score in both populations, and dosing schedules were not important at all, with a 2% importance score for pollen and an 11% importance score for venom-allergic patients. Accumulation of foreign material/substance in the body had the largest negative impact on patient preference, with drops of −24.7% (pollen) and −23.6% (venom), respectively. Understanding patient preferences is essential for optimizing the design and delivery of AIT. Different side effects and risk profiles of AIT products can influence patient treatment acceptance the most, and healthcare professionals may not always be aware of it. Future research should focus on developing AIT products that align with patient preferences with simultaneously very high effectiveness to improve adherence and treatment outcomes.

Background/Objectives: The guideline on allergen-specific immunotherapy of the European Academy of Allergy and Clinical Immunology recommends subcutaneous allergen-specific immunotherapy for the treatment of allergic rhinitis in children and adults with moderate to severe symptoms. The five years cohort study described below was designed in 2020 to demonstrate non-inferiority in terms of safety, tolerability and efficacy in a paediatric population compared with adult patients treated with microcrystalline tyrosine-adsorbed allergoids for their tree and grass pollen allergy in a perennial setting. Here, we present the preliminary findings from the first year. Methods: The Combined Symptom and Medication Score was chosen as the primary endpoint of this therapy. Secondary endpoints include the Rhinoconjunctivitis Quality of Life Questionnaire, the retrospective Rhinoconjunctivitis score, the Asthma Control Test and the Rhinitis Control Test, as well as an analysis of adverse drug reactions. Results: A total number of 320 patients were enrolled into this study, with 129 of these patients in the age group between 5 and 17 years and 191 patients in the adult age group. Mean Combined Symptom and Medication Score values did not differ significantly between minors and adults in the first pollen season after treatment induction. The retrospective score showed a strong and significant reduction in rhinoconjunctivitis and asthma symptoms. Treatment was well tolerated, with more than 80% of patients reporting no adverse drug reactions. Conclusions: The validity of this study approach of a cohort study has been confirmed by this first interim analysis for the initial course of therapy in the first year.