Long-term effects of a house dust mite sublingual immunotherapy tablet in an environmental exposure chamber trial

Ann Allergy Asthma Immunol. 2016 Dec;117(6):690-696.e1. doi: 10.1016/j.anai.2016.10.015.

Abstract

Background: Treatment with SQ house dust mite (HDM) sublingual immunotherapy (SLIT) tablet is effective for HDM respiratory allergic disease, but data on long-term effects are lacking.

Objective: Post hoc analyses were conducted to determine the long-term effect of SQ HDM SLIT-tablet on nasal, ocular, and cough symptoms 1 year after discontinuation of treatment.

Methods: Study participants underwent environmental exposure chamber (EEC) challenges at baseline and week 24 in a randomized, placebo-controlled, double-blind trial (NCT01644617) during which participants received daily 12 SQ-HDM, 6 SQ-HDM, or placebo for 24 weeks. Asthma had to be stable, well controlled, and nonsevere. The mean total asthma symptom score (TASS; sum of 3 symptoms: cough, wheeze, and dyspnea) during baseline and week 24 EEC challenge was analyzed in all participants who completed the trial (n = 106). Approximately 1 year after trial completion, another EEC challenge was conducted in a subset of participants (n = 51). Total nasal symptom score (sum of 4 symptoms), total ocular symptom score (sum of 2 symptoms), and cough were assessed.

Results: Compared with baseline and end-of-treatment values, sustained improvement of all symptoms assessed at the 1-year follow-up EEC challenge was evident in participants treated with 12 SQ-HDM. Results with 6 SQ-HDM were less notable. After 24 weeks of 12 SQ-HDM, TASS during EEC challenge was improved 65% vs baseline; at 1-year follow-up, cough was improved 57% vs baseline.

Conclusion: Persistent improvement of nasal and ocular symptoms was observed up to 1 year after completing 24 weeks of 12 SQ-HDM treatment. Beneficial effects on cough were also observed.

Trial registration: clinicaltrials.gov Identifier NCT01644617.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens / administration & dosage
  • Allergens / immunology*
  • Animals
  • Antigens, Dermatophagoides / immunology*
  • Asthma / diagnosis
  • Asthma / immunology
  • Asthma / therapy
  • Environmental Exposure / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypersensitivity / diagnosis
  • Hypersensitivity / immunology*
  • Hypersensitivity / therapy*
  • Male
  • Phenotype
  • Pyroglyphidae / immunology*
  • Sublingual Immunotherapy*
  • Tablets
  • Time Factors
  • Treatment Outcome

Substances

  • Allergens
  • Antigens, Dermatophagoides
  • Tablets

Associated data

  • ClinicalTrials.gov/NCT01644617