TGA-Registered Alum-Adsorbed Native Subcutaneous Immunotherapy Product
Alustal is a TGA-registered alum-adsorbed native subcutaneous immunotherapy (SCIT) product developed in Europe for the treatment of environmental allergies. It is available in two formulations: a five-grass mix for temperate grass pollen allergy, including rye grass, and a temperate dust mite mix targeting Dermatophagoides pteronyssinus and D. farinae.
Overview
As a native extract, Alustal provides full allergen potency, offering the potential for maximal desensitisation under controlled clinical supervision.
Safety Profile
Being a native extract, Alustal carries a higher risk of local and systemic allergic reactions compared with allergoids. Common side effects include:
Common side effects include:
Mild local swelling or redness at the injection site
Temporary itching or discomfort
Rare systemic reactions, managed with standard emergency procedures in the clinic
Effectiveness
Alustal is effective in reducing symptoms and medication use for patients with grass pollen or dust mite allergies.
Improvements generally appear over several months, with maximum benefit expected over a 3–5 year treatment course.
3–5 year treatment course
Treatment options
Single allergen therapy
Single allergen therapy:
Both single-allergen options available: five-grass mix or dust mite mix as appropriate for the patient.
Multi-allergen therapy
Multi-allergen therapy:
The five-grass mix provides inherent multi-grass coverage. Both formulations allow for targeted or combination approaches within their respective allergen categories.
Both TGA-registered and non-registered options exist.
Clinics must inform patients that all options are privately funded in Australia, with total treatment costs varying from several hundred to several thousand dollars per year.
Administered via subcutaneous injection in clinic
Initial build-up phase with gradual dose increases
Maintenance phase involves less frequent injections for sustained desensitisation
Requires patient monitoring for potential adverse reactions
Patient Suitability
Alustal may be appropriate for patients who:
Have confirmed IgE-mediated grass pollen or dust mite allergy
Seek maximal potential desensitisation
Can attend regular clinic-based injections
Are comfortable with the higher risk profile of native extracts
Australian Context
Not PBS-subsidised; treatment is privately funded
Conclusion
Alustal provides a high-potency, flexible SCIT option for patients with temperate grass pollen or dust mite allergy.
Its native extract formulation allows for maximal desensitisation, while clinic-based supervision ensures safety.
Both five-grass and dust mite formulations align with Australian treatment needs, offering targeted therapy for different patient profiles.
