The following is a summary of “Long-term efficacy of house dust mite sublingual immunotherapy on clinical and pulmonary function in patients with asthma and allergic rhinitis,” published in the May 2024 issue of Allergy & Immunology by Hoshino, et al.
Previous research indicated that house dust mite (HDM) sublingual immunotherapy (SLIT) was effective as an add-on treatment for allergic asthma over 48 weeks. Still, there was limited data on its long-term efficacy. For a study, researchers sought to assess the long-term effects of HDM SLIT on asthma control, lung function, and airway inflammation and remodeling over a 5-year treatment period.
A total of 140 patients with asthma and allergic rhinitis sensitized to HDM were randomly assigned to receive either standard drug therapy alone or in combination with SLIT for 5 years. Evaluations included the 5-item Asthma Control Questionnaire (ACQ-5), Asthma Quality of Life Questionnaire (AQLQ), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), spirometry, quantitative computed tomography, and type 2 biomarkers.
The study found that patients in the SLIT group showed improvements in ACQ-5, AQLQ, and RQLQ scores compared to the control group. SLIT treatment led to increased lung function and a reduced percentage of airway wall area. Additionally, levels of fractional exhaled nitric oxide (FeNO), blood eosinophils, serum-specific IgE for HDM, and total IgE decreased and remained lower during the 5 years in the SLIT group. Changes in type 2 biomarkers correlated with improvements in AQLQ scores. Receiver-operating characteristic analysis demonstrated high predictive value for FEV1% predicted, airway wall area, FeNO, and specific IgE in identifying treatment responders, with multivariate regression analysis identifying FeNO as the strongest predictor of response to SLIT.
HDM SLIT provided sustained benefits over a 5-year period, enhancing lung function and preventing the progression of airway inflammation and remodeling in patients with asthma. The long-term treatment strategy offered substantial advantages for managing asthma.
Reference: jaci-global.org/article/S2772-8293(24)00002-X/fulltext
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