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House dust mite sublingual immunotherapy: Results of a US trial.
- Source :
- Journal of Allergy & Clinical Immunology; Apr2011, Vol. 127 Issue 4, p974-981.e7, 0p
- Publication Year :
- 2011
-
Abstract
- Background: Few trials of sublingual immunotherapy (SLIT) in the United States have been reported. Objective: This randomized, placebo-controlled feasibility SLIT study compared the safety and physiologic effects of high- versus low-dose Dermatophagoides farinae vaccine. Methods: Thirty-one D farinae–sensitive adults with allergic rhinitis with or without mild intermittent asthma were eligible for randomization to high-dose maintenance vaccine (n = 10, 4200 allergen units [approximately 70 μg of Der f 1/d]), low-dose maintenance vaccine (n = 10; 60 allergen units [approximately 1 μg of Der f 1/d]), or placebo (n = 11) over 12 to 18 months. Medication-symptom scores and adverse events were monitored, serum D farinae–specific IgE and IgG4 levels were measured, and bronchial reactivity to D farinae was determined at baseline and 6-month intervals. Results: Of the 31 randomized subjects, 6 withdrew because of non–treatment-ascribed events. Four withdrew because of treatment-ascribed effects: high-dose group, 1 of 10 (gastrointestinal symptoms); low-dose group, 1 of 10 (gastrointestinal symptoms); and placebo group, 2 of 11 (headache and increased nasal symptoms). Thus 21 subjects completed the study: high-dose group, 9; low-dose group, 7; and placebo group, 5. Eleven of the 21 subjects experienced mild-to-moderate gastrointestinal symptoms, throat irritation, or both (high-dose group, 5/9; low-dose group, 4/7; and placebo group, 2/5). No severe systemic reactions were noted. No differences in symptom-medication scores were found. High-dose SLIT increased the bronchial threshold to allergen challenge and increased serum D farinae–specific IgG4 levels, whereas low-dose SLIT and placebo had no significant effect. Conclusions: High-dose D farinae SLIT was generally tolerable, increased serum D farinae–specific IgG4 levels, and improved the bronchial threshold to allergen challenge. Larger US trials are warranted. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00916749
- Volume :
- 127
- Issue :
- 4
- Database :
- Supplemental Index
- Journal :
- Journal of Allergy & Clinical Immunology
- Publication Type :
- Academic Journal
- Accession number :
- 59772060
- Full Text :
- https://doi.org/10.1016/j.jaci.2010.11.045