Update on house dust mite immunotherapy

PURPOSE OF REVIEW: Although systematic reviews have confirmed the effectiveness of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) for the treatment of allergic rhinitis and allergic asthma, a review of studies employing extracts of house dust mites (HDMs) for immunotherapy found no consensus on basic treatment parameters. RECENT FINDINGS: Over the last 2 years nine additional reports on immunotherapy with HDM extract preparations have been published. Six studies were with SLIT, five for allergic rhinitis and one for allergic asthma. The other three studies were all with SCIT in children with allergic asthma. SUMMARY: The publication of these nine studies supports the efficacy of HDM-SLIT for allergic rhinitis and asthma and for HDM-SCIT for asthma in children. The reported safety data are also reassuring, especially for SLIT.HDM-SLIT tablets under development will have optimal doses established in large, randomized, placebo-controlled trials. The HDM-SCIT trial in children with allergic asthma confirms the efficacy of a commercialized HDM preparation for injection immunotherapy. However, the information that is presented on dosing in the articles on SLIT-liquid is unsatisfactory, as doses are not presented in a form that the clinician can use to guide their practice.