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Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
Published on: March 3, 2023
Steroid Sparing Effect of 300IR House Dust Mite Sublingual Immunotherapy Tablet in Mite Allergic Rhinitis
Oliver Pfaar1, Pascal Demoly2, Philippe Gevaert3
1Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
Background:
In a large randomized controlled trial (NCT02443805) in moderate-to-severe house dust mite (HDM) allergic rhinitis (AR) patients with/without controlled asthma, the 300IR HDM sublingual immunotherapy (SLIT) tablet confirmed its efficacy in reducing symptoms and rescue medication (RM) use. This post hoc analysis aimed at assessing the potential steroid sparing effect of this tablet.
Methods:
Participants receiving 300IR HDM SLIT-tablet or placebo for ∼12 months could use antihistamines (AH1), corticosteroids (CS - intranasal (INCS), or oral (OCS)) in a stepwise manner for subjective intolerable nasal/ocular symptoms. The proportions of patients and days with RM intake (overall and by drug class) were assessed over time and compared between groups (Chi-squared or Wilcoxon rank-sum tests). An odds that is, ratio of probability of using CS/probability of not using CS was calculated. Mean weekly CS doses were analyzed by ANCOVA.
Results:
Of 1262 evaluable patients, ∼60% used at least one CS at baseline: 300IR = 373 and placebo = 396. During treatment, the proportions of patients using RM, oral AH1, and CS and of days with RM use decreased in both groups, systematically in favor of 300IR (p < 0.05 at end-of-treatment). Odds results indicated SLIT-patients were more likely not to use CS, whereas placebo-patients were more likely to use CS (p < 0.05 at end-of-treatment). After 12 months, 54% SLIT-patients were able to discontinue CS completely versus 42% placebo-patients (p = 0.0007). Those who were still using CS were taking fewer and lower doses than placebo-patients.
Conclusions:
In moderate to severe HDM-AR patients, the 300IR HDM SLIT-tablet showed a steroid sparing effect.
Insights
The 300IR house dust mite (HDM) sublingual immunotherapy (SLIT) tablet significantly reduced corticosteroid (CS) use in patients with allergic rhinitis (AR). This HDM SLIT-tablet demonstrated a steroid-sparing effect, allowing more patients to discontinue CS.
Area of Science:
- Allergen immunotherapy
- Respiratory medicine
- Clinical immunology
Background:
- House dust mite (HDM) allergic rhinitis (AR) is a common condition.
- Sublingual immunotherapy (SLIT) is an effective treatment for AR.
- The 300IR HDM SLIT tablet has shown efficacy in reducing AR symptoms and rescue medication use.
Purpose of the Study:
- To assess the steroid-sparing effect of the 300IR HDM SLIT tablet.
- To evaluate the reduction in corticosteroid (CS) use in patients with moderate-to-severe HDM-AR.
- To compare CS use between patients receiving HDM SLIT and placebo.
Main Methods:
- A post hoc analysis of a randomized controlled trial (NCT02443805) was conducted.
- Patients received either the 300IR HDM SLIT tablet or placebo for approximately 12 months.
- Corticosteroid (CS) use was monitored, and statistical analyses were performed to compare CS use between groups.
Main Results:
- A significantly higher proportion of patients on 300IR HDM SLIT were able to discontinue CS compared to placebo (54% vs. 42%).
- Patients receiving HDM SLIT were more likely to not use CS and used lower doses when CS was still required.
- The steroid-sparing effect was statistically significant at the end of the treatment period.
Conclusions:
- The 300IR HDM SLIT tablet demonstrated a significant steroid-sparing effect in patients with moderate to severe HDM-AR.
- This finding suggests that HDM SLIT can be a valuable tool in reducing reliance on corticosteroids for AR management.
- The study supports the use of HDM SLIT as a steroid-sparing treatment option for allergic rhinitis.
