SAN ANTONIO — Adults with dust-mite allergy respond better to sublingual immunotherapy compared with standard allergy medications, according to Italian researchers.
“The clinical efficacy of sublingual immunotherapy has been previously established in pollen, but not dust-mite allergy,” said lead author Carlo Lombardi, M.D., who presented his research at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
While the effect of sublingual immunotherapy is relatively easy to assess in pollen allergy, its effect on year-round dust-mite allergy has been more difficult to assess, added Giovanni Passalacqua, M.D., a coauthor of the study.
But, over a 3-year study period, the investigators observed a significant reduction in nasal obstruction, itching and cough, and a decreased need for symptom-relief medications in patients treated with sublingual immunotherapy compared with those treated with standard medications for allergic rhinitis and asthma.
The study randomized 68 patients with mild dust-mite rhinitis and/or asthma to standard medication plus sublingual immunotherapy or standard medication plus placebo for 1 year. Drug consumption and allergy symptom scores were tracked through diary cards, and the Short Form-36 Quality of Life Questionnaire.
Compared with patients receiving placebo, patients treated with sublingual immunotherapy experienced a significant reduction in symptoms. The treated group was also significantly less likely to report at least 1 missed day of work due to asthma (25% vs. 43%), said Dr. Lombardi.
There was no change in the quality of life in both groups, he said, adding that at baseline, all patients displayed a normal QOL profile. But sublingual therapy patients reported an overall improvement in their 'change in health status,'” he said.
The study results are “revealing and important to the practice of allergy medicine worldwide,” commented Clifford W. Bassett, M.D., medical director of Allergy & Asthma Care of New York.
Although sublingual immunotherapy has been a part of clinical practice in many parts of Europe for the past decade, and in Italy is used more commonly than the subcutaneous route of administration (70% vs 30%), according to Dr. Passalacqua, it remains unapproved by the Food and Drug Administration.
“This and other research is fairly convincing that sublingual immunotherapy is effective when given correctly, at the proper dosage, and the right time. And its safety seems to be quite good from what we've seen so far,” said Dr. Bassett.