Can Oral Dust Mite Immunotherapy Asthma Exacerabtions? Interview with:

Prof Dr. med. J. Christian Virchow, FRCP, FCCP, FAAAA University of Rostock, Germany

Prof. Christian Virchow

Prof Dr. med. J. Christian Virchow, FRCP, FCCP, FAAAA
University of Rostock, Germany

What is the background for this study? What are the main findings?

Dr. Virchow: House Dust mite related allergic asthma is a very frequent chronic disease. Allergen Immunotherapy (AIT) for this condition in asthma has not been well studied and subcutaneous treatment has been associated with (systemic, potentially serious) side effects. Aim of the study was to investigate, if sublingual AIT can improve a patient relevant endpoint, namely reduce the frequency of exacerbations (primary endpoint: time to first exacerbation compared to placebo) . What should clinicians and patients take away from your report?

Dr. Virchow: According to the results of this large, double-blind, placebo-controlled three arm, multi-dose study time to first exacerbations can be reduced in patients with HDM-related allergic asthma if treated with a sublingual immunotherapy tablet containing the 2 major allergens of the two major house dust mites Dermatophagoides pteronyssinus and D. farinae. Thus, patients with insufficiently controlled HDM-related asthma on inhaled corticocosteroids could profit from administration of such a AIT . What recommendations do you have for future research as a result of this study?

Dr. Virchow: The study’s duration was one year. Conventionally, Allergen Immunotherapy is administered for 3 – 5 years. We would like to know if the effect builds over time, if the effects can also be observed in children (who might profit even more based on the fact that allergen-symptom relationship in children is more direct than in adults) and if the treatment can prevent the development of asthma in patients with allergic rhinitis and/or can prevent the development of subsequent sensitizations. Is there anything else you would like to add?

Dr. Virchow: It is the first large scale study to show that Allergen Immunotherapy can influence patient relevant endpoints in asthma. Thank you for your contribution to the community.


Christian Virchow, Vibeke Backer, Piotr Kuna, Luis Prieto, Hendrik Nolte, Hanne Hedegaard Villesen, Christian Ljørring, Bente Riis, Frederic de Blay.

Efficacy of a House Dust Mite Sublingual Allergen Immunotherapy Tablet in Adults With Allergic Asthma. JAMA, 2016; 315 (16): 1715 DOI:10.1001/jama.2016.3964

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on April 28, 2016 by Marie Benz MD FAAD