SQ house dust mite sublingual immunotherapy tablet subgroup efficacy and local application site reaction duration

Ann Allergy Asthma Immunol. 2018 Jul;121(1):105-110. doi: 10.1016/j.anai.2018.04.007. Epub 2018 Apr 12.

Abstract

Background: Allergic rhinitis with or without conjunctivitis (AR/C) is common, necessitating evaluation of SQ house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet efficacy in various subgroups.

Objective: To evaluate 12 SQ-HDM efficacy and safety across subgroups, and the onset, duration, and recurrence of local application site reactions.

Methods: Subgroup (age, sex, race, asthma status, and allergen sensitization) efficacy was assessed using pooled data from 2 previously described trials of daily 12 SQ-HDM vs placebo for AR/C (n = 2,138). Efficacy was measured by average total combined rhinitis score (TCRS; rhinitis daily symptom plus medication score) during the last 8 weeks of treatment. Safety in subgroups and local application site reaction onset, duration, and recurrence were evaluated using pooled data from 5 previously described trials of SQ HDM SLIT-tablet (n = 2,923).

Results: Significant (based on 95% confidence intervals [CIs]) reduction in TCRS was seen with 12 SQ-HDM relative to placebo across all subgroups, with TCRS improvements ranging from 15% to 25%. The AE profile was generally similar within subgroups. Approximately 95% of local application site reactions were mild to moderate in severity. Median duration on day 1 of treatment for the most common local application site reactions (throat irritation, oral pruritus, ear pruritus, and lip swelling) ranged from 30 to 60 minutes; median first day of onset ranged from days 1 to 4 of treatment; median days that reactions recurred ranged from 3 to 12 days.

Conclusion: Treatment with 12 SQ-HDM consistently improved symptoms and was well tolerated in relevant subgroups of subjects with HDM AR/C. Local application site reactions to 12 SQ-HDM were typically mild to moderate and transient.

Trial registration: ClinicalTrials.gov NCT01700192 NCT01454544 NCT00389363 NCT01644617.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Allergens / administration & dosage*
  • Allergens / adverse effects
  • Allergens / immunology
  • Animals
  • Antigens, Dermatophagoides / administration & dosage*
  • Antigens, Dermatophagoides / adverse effects
  • Antigens, Dermatophagoides / immunology
  • Child
  • Conjunctivitis / immunology
  • Conjunctivitis / physiopathology
  • Conjunctivitis / therapy*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pruritus / etiology
  • Pruritus / immunology
  • Pruritus / physiopathology
  • Pyroglyphidae / chemistry
  • Pyroglyphidae / immunology
  • Recurrence
  • Rhinitis, Allergic / immunology
  • Rhinitis, Allergic / physiopathology
  • Rhinitis, Allergic / therapy*
  • Sex Factors
  • Sublingual Immunotherapy / methods*
  • Tablets
  • Treatment Outcome

Substances

  • Allergens
  • Antigens, Dermatophagoides
  • Tablets

Associated data

  • ClinicalTrials.gov/NCT01700192
  • ClinicalTrials.gov/NCT01454544
  • ClinicalTrials.gov/NCT00389363
  • ClinicalTrials.gov/NCT01644617