House dust mite-specific immunotherapy with two licensed vaccines: Outcome under clinical routine conditions

Abstract

IntroductionHouse dust mite (HDM) allergens are major causes for the development of allergic diseases. A disease modifying effect and clinical benefit of allergen immunotherapy (AIT) has been demonstrated in a number of clinical trials. Clinical trials, however, are carried out in selected populations under specific conditions based on inclusion and exclusion criteria and may not represent the entire patient population from medical practice. Objective of this study conducted in patients with HDM allergy was to systematically collect information about the benefit of AIT under clinical routine conditions.MethodsIn this prospective, multi‐center non‐interventional study, 220 patients (117 adults, 103 children) with HDM allergy receiving subcutaneous AIT with Depigoid® were monitored for 2 years. Organ‐specific key symptoms, health‐related quality of life (QoL), and the use of concomitant anti‐allergic medication were assessed at baseline and after 12 and 24 months. Effectiveness and tolerability of the AIT was assessed by physicians and patients. Occurrence of adverse events (AEs) was continuously monitored.ResultsTwo hundred and nineteen patients (116 adults, 103 children) were evaluated. A major improvement of the total symptom‐score was observed after 24 (12) months in 76% (72%) and 80% (79%) of adults and children, respectively, accompanied by a reduction in concomitant anti‐allergic medication and a pronounced improvement in QoL. The effectiveness and tolerability of the AIT was estimated as very good/good by 80–90% of physicians and patients. AEs were observed in 4/117 adults (3.4%) and in 7/103 children (6.8%). Serious AEs were reported in three adults and one child: A grade‐II anaphylactic reaction (one adult) controlled by oral antihistamines (no hospitalization) classified as “definitely,” three others as not (2) or possibly (1) drug‐related.ConclusionsThe data collected from 220 patients confirm the efficacy, tolerability/safety, and acceptance of AIT with Depigoid® in adults and children with HDM allergy under routine clinical conditions.

Quality of life improvement with allergen immunotherapy treatment in patients with rhinoconjunctivitis in real life conditions. Results of an observational prospective study (ÍCARA)

“…The positive changes in RQLQ observed in this study, are in the same line that those previously reported in some randomized clinical trials where this effect has been evaluated for AIT (21,22,36,37). Nowadays, few observational studies, under clinical routine conditions, have shown the benefits of AIT treatment in improving the QoL of patients with AR (38,39). Interestingly, Schwanke et al (40) in 2017 published a observational study with the objective to compare changes in QoL with sublingual immunotherapy (SLIT) and SCIT treatments in patients with AR in a real-world clinical setting.…”

EAACI Guidelines on Allergen Immunotherapy: House dust mite‐driven allergic asthma

“…All local AEs related to the study drug (erythema, swelling, and pain at the injection site). Serious AEs were reported in three adults and one child: a grade‐II anaphylactic reaction (one adult) controlled by oral antihistamines (no hospitalization) classified as “definitely,” three others as not (2) or possibly (1) drug‐related …”

Clinical trial to assess tolerability and subrogate efficacy effects of an abbreviated schedule with house dust mites mixture subcutaneous immunotherapy

“…modifying effect, specific AIT gets immune system tolerance to clinically relevant allergens through triggering specific blocking antibodies, activating mediators and achieving the decrease of the inflammatory response in tissues. Probably, the AIT prescription is considerably lower than 10% of patients with AR or asthma (12,13).…”