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House dust mite SLIT reduced need for inhaled corticosteroids

Standard quality house dust mite sublingual immunotherapy tablets maintained asthma control while reducing the need for inhaled corticosteroids in patients aged 14 years or older, according to recently published data.

“Nearly all patients with allergic asthma and [house dust mite] sensitization also have allergic rhinitis, and approximately half of the patients with allergic rhinitis and [house dust mite] sensitization also have asthma,” the researchers wrote. “Therefore, it appears that a treatment addressing the underlying [house dust mite] respiratory allergic disease might have beneficial effects on clinical symptoms manifesting either as allergic rhinitis, allergic asthma, or both.”

Holger Mosbech, MD, of the allergy unit at Copenhagen University Hospital Gentofte, Denmark, and colleagues randomly assigned 604 patients aged 14 years or older with house dust mite allergic rhinitis and mild-to-moderate asthma in a 1:1:1:1 fashion to one of three active doses (6, 3 or 1) of standard quality (SQ) house dust mite (HDM) sublingual immunotherapy (SLIT) or placebo.

Primary data indicated that the daily inhaled corticosteroids (ICS) dose was reduced from baseline by 208 mcg (adjusted mean) for 6 SQ-HDM and 126 mcg for placebo; demonstrated a reduction of ICS by 81 mcg daily for 6 SQ-HDM vs. placebo (P=.004), according to researchers.

Adverse events occurred more commonly for 3 and 6 SQ-HDM compared with 1 SQ-HDM and placebo, and included oral pruritus.

“With the demonstration of comparable efficacy and improved safety relative to what is usually observed for [subcutaneous immunotherapy], the trial provides new information to be included in the benefit/risk evaluation of different classes of [allergy immunotherapy] in asthmatic patients,” the researchers wrote.

Disclosure: See the study for a full list of relevant financial disclosures.