House Dust Mite Sublingual Immunotherapy and Allergic Asthma

House dust mite sublingual immunotherapy may be effective for allergic asthma, according to a recent study published in the Journal of Allergy and Clinical Immunology: In Practice.

House dust mite sublingual immunotherapy (HDM SLIT) effectively treats allergic rhinitis (AR). However, the evidence of HDM SLIT for allergic asthma remained limited.

A study was conducted to systematically review the efficacy and safety of HDM SLIT tablets in patients with allergic asthma.

Researchers performed a systematic search through PubMed, Scopus, EMBASE, Web of Science, the Cochrane Center of Controlled Trials, and Google Scholar for randomized controlled trials (RCTs) that addressed the efficacy and safety of HDM SLIT tablets compared with placebo or no intervention in allergic asthma from their inception date until September 2021. The primary outcome was the reduction in inhaled corticosteroid (ICS) dose. Additional outcomes were asthma control, exacerbation, lung function, quality-of-life, and adverse events (AEs).

Results of the Study

• There were seven RCTs, 5 studies in allergic asthma (4 in adults and one in children), and 2 in AR with or without asthma.
• The 6 SQ-HDM effectively reduced ICS dose in well- to partly-controlled mild-to-moderate asthma in 1 RCT.
• Two RCTs evaluated the efficacy of 6 SQ- and 12 SQ-HDM in reducing asthma exacerbation in partly-controlled moderate-to-severe asthma, and their results were inconsistent.
• One study in children with mild-to-moderate asthma found no benefit of HDM SLIT.
• Two RCTs in AR with or without mild-to-moderate asthma showed improvement of asthma symptoms.
• AEs were primarily local, and anaphylaxis treated with epinephrine was reported in 3 patients.

Thus, HDM SLIT tablets tend to effectively reduce ICS use in adults and adolescents with well- to partly-controlled mild-to-moderate allergic asthma with a favorable safety profile.

Reference

Efficacy and safety of house dust mite sublingual immunotherapy tablet in allergic asthma: A systematic review of randomized controlled trials by Chamard Wongsa et al. published in The Journal of Allergy and Clinical Immunology: In Practice.

Read the full study