SQ-HDM SLIT for treating allergic rhinitis and allergic asthma caused by house dust mites

Allergic rhinitis/rhinoconjunctivitis (AR/C) induced by house dust mites (HDM) often begins in childhood and negatively impacts a child’s quality of life (1):

• HDM-induced AR/C (HDM AR/C) is usually characterised by persistent symptoms, which are most pronounced during autumn and winter periods
• allergen immunotherapy (AIT) is the only treatment option for AR/C that targets the underlying cause of allergic disease
  • inducing immunological tolerance to the causative allergen is initiated through repeated administration of AIT; for sublingual immunotherapy (SLIT)-tablets, daily administration for 3 years is recommended to achieve a sustained disease-modifying effect
    • SQ HDM SLIT-tablet provides a standardized extract of house dust mite allergens, delivered in tablet form under the tongue (sublingually)
    • onset of clinical effects with AIT is usually observed approximately 2-3 months after initiation, as has been shown in various studies of the SQ HDM SLIT-tablet in adults/adolescents with HDM AR/C
    • efficacy and safety of SQ HDM SLIT-tablet in treating AR/C have been demonstrated in clinical studies in adults and adolescents

NICE state with respect to allergic rhinitis (2):

• 12 standard quality house dust mite sublingual lyophilisate (SQ-HDM SLIT) is recommended, within its marketing authorisation, as an option for treating moderate to severe house dust mite allergic rhinitis in people 12 to 65 years that is:
  • diagnosed by clinical history and a positive test of house dust mite sensitisation (skin prick test or specific immunoglobulin E [IgE]) and
  • persistent despite use of symptom-relieving medicine

The NICE committee noted that:

"..Clinical trial evidence suggests that, compared with placebo plus standard care, 12 SQ‑HDM SLIT plus standard care may reduce:

• rhinitis symptoms and medicine use in people with house dust mite allergic rhinitis, and
• asthma exacerbations in people with house dust mite allergic asthma.

...There is more uncertainty about the clinical effectiveness of 12 SQ-HDM SLIT for allergic asthma than for allergic rhinitis"

Reference:

1. Schuster SA et al. Efficacy and safety of SQ house dust mite sublingual immunotherapy-tablet (12 SQ-HDM) in children with allergic rhinitis/rhinoconjunctivitis with or without asthma (MT-12): a randomised, double-blind, placebo-controlled, phase III trial. Lancet Reg Health Eur. 2024 Nov 26;48:101136.
2. NICE (March 2025). 12 SQ-HDM SLIT for treating allergic rhinitis and allergic asthma caused by house dust mites.