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Shorter therapy effectively treated pediatric patients’ allergies to dust mites

Three years of specific immunotherapy treatment was adequate for pediatric patients with asthma associated with house dust mite allergies compared with 2 additional years of therapy that produced no further benefits in a recent study.

In comparing 3- and 5-year regimens for specific immunotherapy treatment (SIT), researchers conducted a 3-year natural history study of 90 pediatric patients with allergy sensitivity only to house dust mites (HDM). Eighty-four patients in Poland were followed after completing either 3 years of therapy (SIT3; n=30), 5 years of therapy (SIT5; n=24) or no therapy (controls whose parents refused SIT for their children, n=30). After enrollment, all patients had three yearly follow-ups after completion or refusal of therapy. Researchers measured long-term effectiveness of SIT by assessing forced expiratory volume in 1 second (FEV₁), reduction in inhaled corticosteroids (ICS) and asthma remission.

Asthma remission — defined as absence of any symptoms requiring medication for at least 12 months — in SIT3 and SIT5 patients was comparable (50% vs. 54.2%) compared with controls (3.3%). One year after SIT was discontinued, ICS dose reduction in SIT5 patients was significantly greater than in the SIT3 group (75% vs. 50%, median). At 3 years, however, no differences were observed between the groups (100% vs. 94%, median; P=.62), while the SIT5 group had a slightly higher FEV₁ compared with SIT3 patients (98% vs. 92.5%; P=.53).

“We believe that 3 years of SIT is an adequate duration for the treatment of childhood asthma caused by HDM because 2 additional years of SIT added no disease duration benefit and only a possible benefit to FEV₁,” the researchers concluded. “An observation period longer than 3 years is needed to assess whether a 5-year course might be more effective.”