Sublingual Allergen Immunotherapy Could Reduce Asthma Exacerbations

A recent study found that adding a house dust mite (HDM) sublingual allergen immunotherapy (SLIT) reduces the likelihood of moderate or severe asthma exacerbation in patients with HDM-related asthma.

This study, published in JAMA, included 834 adults with HDM allergy-related asthma not well controlled by inhaled corticosteroid (ICS) or combination products and with HDM allergy-related rhinitis.

Patients were randomized into once-daily treatment cohorts, with 277 patients receiving a placebo and 275 and 282 patients in HDM SLIT tablet cohorts receiving a different dosage. Patients also received ICS and the short-acting beta2-agonist salbutamol.

The efficacy of the drug was evaluated at the end of the trial when ICS was reduced by 50% for 3 months and withdrawn for 3 months.

Researchers discovered that cohorts receiving either dosage of the HDM SLIT tablet reduced the risk of moderate or severe asthma exacerbation significantly compared with the placebo cohort.

In the HDM SLIT cohorts, there was also an increase in the allergen-specific immunoglobulin G4 compared with the placebo cohort, but there was no difference in the answers on the asthma control questionnaire or asthma quality-of-life questionnaire for either HDM SLIT group.

No severe allergic reactions were reported.

"To our knowledge, this is the first controlled trial to show that adult patients with HDM allergy-related asthma who were not well controlled taking ICS can achieve an improvement in asthma control as measured by time to first asthma exacerbation with a sublingual tablet formulation of HDM allergen immunotherapy," the study authors conclude.