Fast up-dosing with a birch allergoid is safe and well tolerated in allergic rhinitis patients with or without asthma.

Aim: Subcutaneous immunotherapy is effective in treating allergic rhinoconjunctivitis and asthma, but is still inconvenient when heavy schedules are used. A faster dose escalation is desirable.

Materials & Methods: In this open-label, Phase II trial, 130 adults were randomized 1:1 to receive a birch pollen allergoid subcutaneous immunotherapy. Group I with four weekly injections and Group II with seven weekly injections. Safety, tolerability and immunogenicity were assessed.

Results: Mild-to-moderate treatment-related adverse events were reported for 57.7% of the patients (Group I: 36, Group II: 39). Tolerability was assessed by physicians and rated as 'good' or 'very good' for 55 patients in Group I (87.3%) and for 63 patients in Group II (94.0%). Levels of IgG and IgG increased before and after treatment significantly (p < 0.0001) in both groups.

Conclusion: Standard versus fast dose escalation is comparable in terms of safety and tolerability.