Safety and Efficacy of House Dust Mite Sublingual Immunotherapy Tablet

In both adolescents and adults with allergic rhinitis/conjunctivitis, the efficacy and safety of house dust mite sublingual immunotherapy (HDM-SLIT) tablets appear to be similar. These were among the findings of a study presented at the American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting in New Orleans, LA, November 4 to 8, 2021.

The findings presented were from a post-hoc analysis of 2 double-blind, placebo-controlled trials — 1 in North America (ClinicalTrials.gov identifier: NCT01700192) and the other in Japan. Participants included in the analysis were all at least 12 years of age and had house dust mite-induced allergic rhinitis/conjunctivitis. Individuals were randomized to approximately 1 year of 12 standardized quality (SQ) HDM-SLIT tablets or placebo. The primary study endpoint was the average total combined rhinitis score (TCRS) — that is, the sum of the rhinitis daily symptom and medication scores over the last 8 weeks of treatment.

In the North American portion of the study, the average TCRS with 12 SQ-HDM-SLIT tablets vs placebo improved by 19% (mean difference, –1.00; P =.02) among a total of 189 adolescents and by 16% (mean difference, –0.70 vs placebo; P <.001) in 1292 adults.  In contrast, in the Japanese trial, the average TCRS with 12 SQ-HDM-SLIT tablets vs placebo improved by 19% (mean difference, –0.96; P =.04) among a total of 206 adolescents and by 20% (mean difference, –1.04 vs placebo; P =.001) in 427 adults. 

Rates of adverse events reported among adolescent and adult participants in the HDM SLIT-tablet group were similar in both the North American trial (95% vs 90%, respectively) and the Japanese study (93% vs 89%, respectively). In both studies, local application-site reactions were the most commonly reported adverse events among adolescents and adults.

The researchers concluded that with house dust mite sensitivity commonly observed among adolescents and adults with allergic rhinitis/conjunctivitis, use of the HDM SLIT-tablet seems to be safe and efficacious in both patient populations.

Reference                                                                               

Bernstein D, Nelson H, Sussman G, Okubo K, Maekawa Y, Nolte H. Similar efficacy and safety between adolescents and adults receiving house dust mite sublingual immunotherapy tablet. Presented at: American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting; November 4-8, 2021; New Orleans, LA.  Abstract P030.