House dust mite immunotherapy in allergic rhinitis was shown to be effective in trials with a relatively small number of participants. The authors of this study performed a multicentre double-blind randomised controlled trial to investigate effects of house dust mite sublingual immunotherapy in 968 subjects aged between 12 and 64 years old. They randomised the subjects into two concentrations of sublingual immunotherapy (300 index of reactivity (IR) and 500 IR) and a placebo. They found significant improvement in Average Adjusted Symptom Score (AASS) in the last eight weeks of the 52-week treatment in the active treatment groups. The Japanese Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) scores improved in the lower concentration of the active treatment group. There were no significant adverse events in the three groups. The authors conclude that both concentrations of the sublingual immunotherapy for house dust mite were effective without major safety concerns. They recommended a therapeutic dose of 300 IR. The study included both adults and children, which could limit future comparison and meta-analysis. It also used different outcome measures to those more commonly used in other studies such as sinonasal outcome test (SNOT-20). However, it adds to the evidence supporting safety and efficacy of sublingual house dust mite immunotherapy for allergic rhinitis.

House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis.
Okamoto Y, Fujieda S, Okano M, et al.
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Hassan Mohammed

North East Deanery, Newcastle, UK.

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