A sublingual immunotherapy tablet for treating house dust mite allergy

Published: September 2, 2020

Allergic rhinitis (AR) is a highly prevalent but often underdiagnosed and undertreated/untreated chronic disease. One of the main triggers for respiratory allergies like AR is the house dust mite (HDM), which produces a wide range of allergens and is present in almost all domestic environments. Although the symptoms of respiratory allergies can be relieved temporarily by symptomatic medications (such as antihistamine tablets and corticosteroid sprays or tablets), allergen immunotherapy is the only treatment that can modify the underlying immune disease. Various allergen formulations and administration routes have been tested and approved for the treatment of moderate-to-severe AR induced by HDMs or other allergens.

In a recent article published in The Journal of Allergy and Clinical Immunology (JACI), Demoly and colleagues described a large Phase III, international, double-blind, randomized clinical trial in which the participants received approximately 12 months of treatment with either a placebo tablet or a 300 index of reactivity (IR) tablet formulation of an HDM allergen extract. The primary efficacy endpoint was the average total combined score (TCS, taking account of both allergy symptoms and “rescue” medication use) during 4 weeks at the end of the treatment period.

Demoly and colleagues reported that on average, the TCS during the evaluation period was significantly lower (i.e. patients experienced less severe symptoms and used less medication overall, including fewer corticosteroids) in the HDM tablet group than in the placebo group. Furthermore, the patients treated with the HDM tablet enjoyed better quality of life and had a greater proportion of symptom-controlled days than patients treated with a placebo tablet. As expected for sublingual allergen immunotherapy, side effects (mainly mild or moderate irritation of the mouth or throat during the first few days of treatment) were more frequent in the HDM tablet group but were not generally serious or persistent.

The researchers concluded that the 300° IR sublingual tablet was an effective, safe treatment for HDM-induced AR. They suggested that this treatment option minimizes the need for “rescue” medication and provides effective symptom relief.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.