House dust mites after a common trigger for allergic asthma. Guidelines recommend house dust mite sublingual immunotherapy as add-on therapy for patients with house dust mite-related allergic asthma.
Allergen-specific immunotherapy (ASI) has been used as a disease-modifying treatment to relieve symptoms in patients with IgE-mediated allergic conditions, including allergic asthma. House dust mites (HDMs) are a significant trigger in allergic asthma, and HDM sublingual immunotherapy (SLIT) has been effective in improving symptoms and reducing exacerbations in patients with asthma.
The Global Initiative for Asthma (GINA) and European Academy of Allergy and Clinical Immunology (EAACI) guidelines recommend HDM SLIT as add-on therapy for patients with HDM-related allergic asthma that is not controlled with pharmacotherapy.
A study published last month in Allergology International evaluated the safety and efficacy of HDM SLIT combined with Dupixent (dupilumab) in controlling asthma in patients with allergic asthma not controlled by their current Dupixent therapy. Dupixent, developed by Sanofi and Regeneron Pharmaceuticals, is a fully human monoclonal antibody that inhibits interleukin (IL)- 4 and IL-13, both of which play a key role in driving severe asthma symptoms. It is approved as add-on treatment for moderate-to-severe asthma.
Study participants received HDM SLIT at the baseline visit and every 4 weeks for 48 weeks in addition to their maintenance therapy, including Dupixent. Patients were evaluated at baseline and 48 weeks following treatment using the asthma control questionnaire (ACQ)-5 and the asthma quality of life questionnaire (AQLQ).
At 48 weeks, 70% of patients responded positively to the HMD SLIT and Dupixent treatment. The investigators found that adding HDM SLIT to Dupixent therapy significantly improved asthma symptoms and pulmonary function, reduced inflammation, and reduced airway wall thickness. No serious adverse events occurred during treatment.
Study limitations include the single-arm design, small sample size, short duration of treatment, and exclusion of asthma exacerbation assessment. The researchers aimed to evaluate the efficacy of adding HDM SLIT to Dupixent treatment in patients with uncontrolled asthma in a real-world setting. They concluded that, “These results support the benefits of adding HDM SLIT to pharmacotherapy plus dupilumab in uncontrolled asthma with rhinitis.”