Successful management of mite-allergic asthma with modified extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae in a double-blind, placebo-controlled study

J Allergy Clin Immunol. 2006 Nov;118(5):1026-32. doi: 10.1016/j.jaci.2006.07.043. Epub 2006 Sep 18.

Abstract

Background: Mite sensitivity is highly prevalent in tropical and subtropical regions, such as the Canary Islands.

Objectives: To evaluate the clinical efficacy and safety of a depigmented polymerized allergen vaccine containing a 50% mixture of Dermatophagoides pteronyssinus and Dermatophagoides farinae.

Methods: Sixty-four patients participated in the study. It was prospective, double-blind, and placebo-controlled, with random allocation of patients to receive active treatment or placebo. The active group received a mixture of modified allergen extracts containing 50% D pteronyssinus and 50% D farinae; the control group received placebo. All individuals were diagnosed with mild/moderate asthma and rhinoconjunctivitis caused by sensitization to D pteronyssinus and D farinae. Bronchial provocation test (BPT) was considered the main outcome to document clinical efficacy.

Results: Fifty-four patients completed the study. The active group experienced a significant improvement in BPT (P < .001), whereas the placebo group did not (P = .648). At the end of the study, 20 patients in the active versus 9 in the placebo group (P = .013; odds ratio, 5.71 [1.76, 18.51]) needed more than twice the amount of allergen to obtain a positive BPT. The median improvement in the active group over placebo was 53.76% in total symptom and 58.09% in medication scores.

Conclusion: Immunotherapy with a mixture of modified allergen extracts of D pteronyssinus and D farinae is safe and efficacious to treat mite-allergic asthma.

Clinical implications: This immunotherapy modifies the natural course of the illness because it improves all clinical outcomes measured and prevents the worsening of specific bronchial hyperreactivity.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Allergens / immunology
  • Allergens / therapeutic use*
  • Animals
  • Antigens, Dermatophagoides / immunology
  • Antigens, Dermatophagoides / therapeutic use*
  • Asthma / immunology*
  • Asthma / physiopathology
  • Asthma / therapy*
  • Dermatophagoides farinae / chemistry
  • Dermatophagoides farinae / immunology*
  • Dermatophagoides pteronyssinus / chemistry
  • Dermatophagoides pteronyssinus / immunology*
  • Desensitization, Immunologic*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Tissue Extracts / immunology
  • Tissue Extracts / therapeutic use*

Substances

  • Allergens
  • Antigens, Dermatophagoides
  • Tissue Extracts