This article in the Drug and Therapeutics Bulletin (DTB) on Grazax, a sublingual formulation of grass pollen, updates the one from 2008 following a change in the marketing authorisation for such that it is now described in the SPC as a “disease-modifying treatment”, and has a license for use in children aged 5 years and above.

The article makes the following points:

• The drug’s effects on hay fever symptoms appear to be modest compared to placebo and patients still need to use symptomatic treatments.

• Following cessation of Grazax, a modest benefit appears to persist for a further season among patients who had taken the drug continuously for 3 years.

• There are still no published comparisons with established symptomatic treatments or with subcutaneous immunotherapy.

• Grazax is expensive

The authors conclude that they “remain unconvinced that Grazax offers worthwhile benefit for the vast majority of patients with hay fever, and cannot recommend its use.”