PQ Grass Allergy Immunotherapy: Shared Decision-Making and What's Next, With Mohamed Shamji, PhD

View part 1 of our conversation with Shamji here.

With 6-injection PQ Grass 27,600 SU now backed by mechanistic and clinical data — including a 22.5% improvement in Combined Symptom Medication Score over placebo (P <.00004) across pooled analyses of PQG309 and PQG306 (n = 75; PQ Grass, n = 40; placebo, n = 35), atop a placebo response commonly reaching 50% — the conversation around allergen immunotherapy is shifting from whether these treatments work to how clinicians and patients choose among an expanding set of options.

In the second part of our conversation with Mohamed Shamji, PhD, Professor of Immunology and Allergy at Imperial College London and Secretary General of the European Academy of Allergy and Clinical Immunology, at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2026 Annual Meeting held in Philadelphia, Pennsylvania, the focus turned to shared decision-making, the evidence gaps he most wants to see addressed, and the broader preventive potential of immunotherapy.

Shamji was emphatic that treatment selection — among subcutaneous, sublingual, and accelerated pre-seasonal regimens like PQ Grass — must be driven by patient preference and lifestyle rather than physician default. Some patients find the structured clinic visit commitment of subcutaneous immunotherapy reassuring; others, particularly frequent travelers or those unable to keep regular appointments, are better served by home-based sublingual tablets. Adherence, he noted, is a persistent challenge across all AIT modalities — paradoxically, in part because immunotherapy works: patients who become symptom-free during treatment may stop taking it, just as they might stop a short course of antihistamines once symptoms resolve. The 6-injection model addresses this directly by compressing the entire pre-seasonal course into a small number of clinic visits, removing the daily compliance burden entirely. For pediatric patients, he added, needle aversion introduces an additional layer of complexity that makes route of administration a particularly important part of the shared decision.

On evidence gaps, Shamji identified objective predictive biomarkers as the priority he most wants to see developed alongside PQ Grass. The mechanistic data from PQG309 and PQG306 already demonstrate a clear tolerogenic immune signature — with statistically significant induction of sIgG, sIgG4, sIgA1, and sIgA2 (P <.001 to P <.01), functional inhibition of allergen-IgE complex binding to B cells pre- and post-season (P <.001 and P <.01 respectively), and suppression of Th2 and Th2A proliferation (P <.05) — but translating those signals into validated, patient-facing biomarkers that can demonstrate treatment trajectory in real time remains an unmet need his group at Imperial is actively working toward.

Finally, Shamji broadened the frame to immunotherapy's preventive dimension — its established ability to prevent new sensitizations and reduce progression to asthma — and previewed early data from his group on virus-like particles expressing the Fel d 1 molecule for cat allergy, which showed promising safety and efficacy in a first-in-human study, pointing toward a new generation of precision immunotherapy platforms he described as the genuinely exciting frontier of the field.

Shamji’s disclosure information was not available.

Reference

Layhadi J, Starchenka S, de Kam PJ, et al. PQ Grass 27600 SU effectively induces tolerogenic properties through modulation of humoral and cellular immune responses for the treatment of seasonal allergic rhinitis. Presented at: AAAAI 2026 Annual Meeting, February 27-March 2, Philadelphia, Pennsylvania. Abstract #L77