Skip to main content
Log in

Dust Mite Tablet Immunotherapy: How Does It Compare and Where Does It Fit?

  • Specific Immunotherapy (L Cox, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Opinion Statement

House dust mite (HDM) sensitization plays a major role in allergic rhinitis and asthma worldwide. Sublingual immunotherapy (SLIT) in its various formulations has been increasingly utilized for the treatment of these conditions in the past several years. HDM-SLIT tablets have been recently introduced with three formulations currently under investigation. SLIT tablets offer the advantage of a more standardized dose than liquid SLIT products. Several studies suggest that HDM-SLIT tablets may be safe and effective in the treatment of allergic rhinitis and asthma in adults, though further investigations will be necessary to fully establish their use in adults and especially in children. The use of HDM-SLIT tablets appears to be very promising and can usher in a new era to potentially stop the “allergic march” from HDM sensitization in early life to the development of asthma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Readings

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Calderon MA, Linneberg A, Kleine-Tebbe J, De Blay F, Hernadez Fernandez de Rojas D, Virchow JC, Demoly P. Respiratory allergy caused by house dust mites: what do we really know? Immunol. 2015;136:38–48. Update of current knowledge of HDM allergy.

    Google Scholar 

  2. Portnoy J, Miller JD, Williams PB, Chew GL, et al. Environmental assessment and exposure control of dust mites: a practice parameter. Ann Allergy Asthma Immunology. 2013;111:465–507.

    Article  Google Scholar 

  3. • Calderon MA, Linneberg A, Kleine-Tebbe J, De Blay F, Hernadez Fernandez de Rojas D, Virchow JC, Demoly P. House dust mite respiratory allergy. Immunol. 2015;3:845–55.Current review of therapeutic options.

    Google Scholar 

  4. Nurmatov U, Van Schayack CP, Hurwitz B, Sheikh A. House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systemic review. Allergy. 2012;67:158–65.

    Article  CAS  PubMed  Google Scholar 

  5. Gotzsche PC, Johnansen HK. House dust mite control measures for asthma. Cochrane Database Syst. Rev 2008 16; (2) CD001187. doi:10.1002/14651858. CD 001187. Pub 3.

  6. Larenas Linnemann D, Blaiss MS. Selection of patients for sublingual versus subcutaneous immunotherapy. Immunotherapy. 2014;6:871–84.

    Article  CAS  PubMed  Google Scholar 

  7. Bene J, Ley D, Roboui R, Gottrand F, Gautier S. Eosinophilic esophagitis after desensitization to dust mites with sublingual immunotherapy. Ann Allergy Asthma Immunol. 2016;116:583–4.

    Article  PubMed  Google Scholar 

  8. Larenas-Linnermann D. Patient selection for subcutaneous versus sublingual immunotherapy. Curr Opin Allergy Clin Immunol. 2015;15:588–95.

    Article  Google Scholar 

  9. Damm K, Volk J, Horn A, Allam JP, Troensegaard-Peterson N, Serup-Hansen N, Winker T, Thiessen I, Borchert J, Wustenberg EG, Mittendorf T. Patient preferences in allergy immunotherapy (AIT) in Germany—a discrete-choice experiment. Health Econ Rev. 2016;6:32.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chester JG, Bremberg MG, Reisacher WR. Patient preference for route of allergy immunotherapy: a comparison of four delivery methods Int Forum Allergy Rhinol. 2016, 6:454–9

  11. Kid MA, Roder E, van Wijk G, Al MJ, Hop WC, Rutten-van Molken MP. Real-life compliance and resistance among users of subcutaneous and sublingual allergen immunotherapy. J. Allergy Clin Immunol. 2013;132:353–60.

    Article  Google Scholar 

  12. Wilson DR, Torres LI, Durham SR. Sublingual immunotherapy for allergic rhinitis Cochrane Database Syst Rev 2003;(2): CD002893

  13. Durham SR, Penagos M. Sublingual or subcutaneous immunotherapy for allergic rhinitis? J. Allergy Clin Immunol. 2016;137:339–49.

    Article  PubMed  Google Scholar 

  14. Lin SY, Erekosima N, Kim JM, Ramanathan M, Suraez-Vuervo C, Chelladurai Y, Ward D, Segal JB. Sublingual immunotherapy for the treatment of allergic rhino conjunctivitis and asthma: a systematic review. JAMA. 2013;309:1278–88.

    Article  CAS  PubMed  Google Scholar 

  15. Noemansell R, Kew KM, Bridgman AL. Sublingual immunotherapy for asthma. Cochrane Database Syst Rev. 2015;8:CD011293.

    Google Scholar 

  16. Liao W, Hu Q, Shen LL, Hu Y, Tao HF, Li HF, Fan WT. Sublingual immunotherapy for asthmatic children sensitized to house dust mite: a meta-analysis. Medicine. 2015;94:e701.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Karakoc-Ayinder E, Eifan AO, Baris S, Gunay E, Akturk E, Akkoc T, Bahceciler NN, Barlan IB. Long term effect of sublingual and subtaneous immunotherapy in dust mite-allergic children with asthma/rhinitis: a 3-year prospective randomized controlled trial. J Investig Allergol Clin Immunol. 2015;25(5):334–42.

    Google Scholar 

  18. Nelson HS, Makatsori M, Calderon MA. Subcutaneous immunotherapy and sublingual immunotherapy: comparative efficacy, current and potential indications, and warnings—United States versus Europe. Immunol Allergy Clin N Am. 2016;36(1):13–24.

    Article  Google Scholar 

  19. Park KH, Son M, Choi SY, Park HJ, Lee JH, et al. In vitro evaluation of allergen potencies of commercial house dust mite sublingual immunotherapy reagents. Allergy Asthma Immunol Res. 2015;7(2):124–9.

    Article  PubMed  Google Scholar 

  20. Nolte H, Plunkett G, Grosch K, Larsen JN, Lund K, Bollen M. Major allergen content consistency of SQ house dust mite sublingual immunotherapy tablets and relevance across geographic regions. Ann Allergy Immunol. 2016;117:298–303.

    Article  CAS  Google Scholar 

  21. Mauro M, Boni E, Makri E, Incorvaia C. Pharmacodynamic and pharmacokinetic evaluation of house dust mite sublingually administered immunotherapy tablet in the treatment of asthma. Expert Opin Drug Metab Toxicol. 2015;11:1937–43.

    Article  CAS  PubMed  Google Scholar 

  22. Bachert C. Treatment of respiratory allergy with allergy immunotherapy tablets. Allergy. 2011;95:57–9.

    Article  Google Scholar 

  23. Maloney J, Prenner BM, Bernstein DI, Lu S, Gawchik S, Berman G, Kaur A, Li Z, Nolte H. Safety of house dust mite sublingual immunotherapy standardized quality tablet in children allergic to house dust mites. Ann Allergy Immunol. 2016;59-65

  24. Corzo JL, Carrillo T, Pedemonte C, Plaza Martin AM, Martin AM, Martin Hurtado S, Dige E, Calderon MA. Tolerability during double-blind randomized phase 1 trials with the house dust mite allergy immunotherapy tablet in adults and children. J Investig Allergol Clin Immunol. 2014;24(3):154–61.

    CAS  PubMed  Google Scholar 

  25. • Bergmann KC, Demoly P, Worm M, Fokkens WJ, Carrillo T, Al T, et al. Efficacy and safety of sublingual tablets of house dust mite allergen extracts in adults with allergic rhinitis. J Allergy Clin Immunol. 2014;133:1608–14. Provides evidence for HDM tablet therapy.

    Article  CAS  PubMed  Google Scholar 

  26. Mosbech H, Deckelmann R, de Blay F, Pastorelllo EA, Trebas-Piertras E, et al. Standardized quality (SQ) house dust mite sublingual immunotherapy tablet (ALK) reduces inhaled corticosteroid use while maintain asthma control: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2014;134:568–75.

    Article  CAS  PubMed  Google Scholar 

  27. De Blay F, Kuna P, Prieto L, Ginko T, Seitzberg D, Riis B, Canonica GW. SQ HDM SLIT-tablet (ALK) in treatment of asthma—post hoc results from a randomised trial. Respir Med. 2014;108:1430–7.

    Article  CAS  PubMed  Google Scholar 

  28. Bahceciler NN, Babayigit Hocaoglu A, Galip N. A milestone in house dust-mite-allergen immunotherapy: the new sublingual tablet S-524101 (actair). Expert Rev Vaccines. 2014;13:1427–38.

    Article  CAS  PubMed  Google Scholar 

  29. Nelson HS. Update on house dust mite immunotherapy: are more studies needed? Curr Opin Allergy Clin Immunol 2014; 542–8

  30. Huser C, Dieterich P, Singh J, Shah-Hosseinin K, Allekotte S, et al. A 12 week DBPC dose-finding study with sublingual monomeric allergoid tablets in house dust mite-allergic patients. Allergy, 2016 Apr 12. doi:10.1111/all.12913.

  31. Demoly P, Emmimger W, Rehm D, Backer V, Tommerup L, Kleine-Tebbe J. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: results from randomized, double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol. 2016;137:444–51.

    Article  CAS  PubMed  Google Scholar 

  32. Okamoto Y, Fujieda S, Okano M, Yoshida Y, Kakudo S, Masuyama K. House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis. Allergy 2016 Jul 29. doi:10.1111/all.12996.

  33. Roux M, Deviller P, Yang WH, Motagut A, Abiteboul K, et al. Efficacy and safety of sublingual tablets of house dust mite allergen extracts: results of a dose-ranging study in an environmental exposure chamber. J Allergy Clin Immunol. 2016;138:451–8.

    Article  CAS  PubMed  Google Scholar 

  34. Nolte H, Bernstein DI, Nelson HS, Kleine-Tebbe J, Sussmann GL, Seitzberg D, Rehm D, Kaur A, Li Z, Lu S. Efficacy of house dust mite sublingual immunotherapy tablet in North American adolescents and adults in a randomized, placebo-controlled trial. J Allergy Clin Immunol. 2016 Aug 10. Pii: S0091-6749(16)30783-7

  35. • Durham SR, Cretocos PS, Nelson HS, Li Z, Kaur A, et al. Treatment effect of sublingual immunotherapy tablets and pharmacotherapies for seasonal and perennial allergic rhinitis: pooled analyses. J Allergy Clin Immunol. 2016;138:1081–8. HDM-SLIT is effective for perennial rhinitis.

    Article  CAS  PubMed  Google Scholar 

  36. Demoly P, Okamoto Y, Yang WH, Devillier P, Bergmann KC. 300 IR HDM tablet: sublingual immunotherapy tablet for treatment of house dust mite-associated allergic rhinitis. Expert Rev Clin Immunol. 2016;12:1141–51.

    Article  CAS  PubMed  Google Scholar 

  37. Klimek L, Mosbech H, Ziglmayer P, Rehm D, Stage BS, Demoly P. SQ house dust mite (HDM) SLIT-tablet provides clinical improvement in HDM-induced allergic rhinitis. Expert Rev Clin Immol. 2016;12:369–77.

    Article  CAS  Google Scholar 

  38. •• Virchow JC, Backer V, Kuna P, Prieto L, Nolte H, Villesen HH, et al. Efficacy of house dust mite sublingual allergen immunotherapy tablet in adults with allergic asthma: a randomized clinical trial. JAMA. 2016;315:1715–25. HDM tablets improve asthma control.

    Article  CAS  PubMed  Google Scholar 

  39. Canonica GWM, Virchow JC, Zieglmayer P, Ljorring C, Smith IM, Mosbech H. Efficacy and safety of SQ house dust mite (HDM) SLIT-tablet treatment of HDM allergic asthma. Expert Rev Clin Immunol. 2016;12:805–15.

    Article  CAS  PubMed  Google Scholar 

  40. Epstein TG, Calabria C, Cox L, Dreborg S. Current evidence on safety and practical considerations for administration of sublingual allergen immunotherapy (SLIT) in the United States. J Allergy Clin Immunol Pract. 2016 Nov 1. Pii S2213–2198(16)30414–7

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert K. Bush MD.

Ethics declarations

Conflict of interest

Dr. Robert K. Bush receives royalties from UpToDate and is a section editor for Current Opinions in Allergy and Immunology and Current Allergy and Asthma Reports.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Specific Immunotherapy

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bush, R.K. Dust Mite Tablet Immunotherapy: How Does It Compare and Where Does It Fit?. Curr Treat Options Allergy 4, 14–21 (2017). https://doi.org/10.1007/s40521-017-0114-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40521-017-0114-8

Keywords

Navigation