> ALLERGY IMMUNOTHERAPY
The standard of care for allergic rhinitis continues to be local and systemic anti-histamines and nasal corticosteroids. These products only lead to alleviation of symptoms and do not prevent the allergic march to more severe disease.
Worg’s approach is to change the paradigm of allergy immunotherapy for patients, physicians and health care providers by introducing next generation therapy. This will improve on all 6 dimensions of current therapies and modify the patient journey and has potential for disease modification.
Allergen specific immunotherapy is the only disease modifying therapeutic intervention. It was first practiced more than 100 years ago by Noon and Freeman, and efficacy has been established through a significant number of clinical studies and meta-analyses, both alleviating patients’ symptoms and preventing the allergic march.
However, the market penetration of AIT remains low at <10% even in those countries where it is well established. The reasons for this poor performance are in many aspects, but mostly are linked to the preparation of most of the available products from crude extracts of pollen and animal materials. These extracts represent a complex and ever-changing mix of allergens with a host of other protein and non-protein material. Despite decades of efforts, they remain notoriously difficult to be standardized, so every manufacturer has established their own standard materials. Furthermore, each extract injection is associated with a IgE stimulus in contrast to Worg’s approach with the recombinant allergens.
On the clinical side, the application of these products is cumbersome and highly inconvenient for patients. Since the treatment is done with the wild-type allergens which are the very cause of the disease. In subcutaneous immunotherapy (SCIT) therapy, treatment has to be started with very low doses until a maintenance dose is achieved. A standard treatment regimen may consist of 50-100 subcutaneous injections, and at any time each injection carries the risk of severe systematic adverse reactions some of which progress to anaphylaxis. As an alternative, sublingual immunotherapy (SLIT) of extracts has been suggested and got some attraction in Europe. Here, a fast dissolving tablet is placed under the tongue every day for at least 3 years. Even though the anaphylaxis risk is lower in SLIT vs SCIT, uncomfortable side effects severely affect adherence to treatment.