Allergic rhinitis due to house dust mites: evaluation of the efficacy of specific sublingual immunotherapy

Abstract

Background: The efficacy and safety of sublingual immunotherapy (SLIT) in patients with chronic rhinitis related to sensitization to house dust mites are still controversial. Methods: After application of an anti‐mite mattress cover, patients were only included in the study when the cumulative symptom score over a fortnight was greater than 70 out of a possible total of 168. Thirty‐two of the 120 patients selected were randomized to receive SLIT for 2 years: 17 received placebo and 15 received the Dermatophagoides pteronyssinus and D. farinae 50/50 allergen extract. Results: Significant between‐group differences were observed after 1 year and persisted at the end of the second year for the rhinitis total score ( P < 0.02), blocked nose score ( P < 0.01) and nasal itching score ( P < 0.01). Skin reactivity to house dust mites was significantly reduced in the group receiving house dust mite extract ( P < 0.03). No statistical difference was observed between the two groups for medication scores, but a low medication consumption was observed in all patients. No serious and no systemic adverse reactions were reported. Conclusion: This study indicates the superiority of active treatment vs . placebo, evaluated on efficacy criteria (rhinitis score) or objective criteria (skin reactivity). The availability of a solid form (tablet) could represent a progress in terms of patient acceptability.