Document Detail

Sublingual-swallow immunotherapy (SLIT) in patients with asthma due to house-dust mites: a double-blind, placebo-controlled study.
MedLine Citation:
PMID:  10321561     Owner:  NLM     Status:  MEDLINE    
A double-blind, placebo-controlled study was carried out in 85 patients with a well-documented history of perennial asthma caused by house-dust mites. Patients received either placebo or sublingual immunotherapy (SLIT) with a standardized Dermatophagoides pteronyssinus (DP)-D. farinae (DF) 50/50 extract. After a run-in period, patients received increasing doses up to 300 IR every day for 4 weeks and then three times a week for the following 24 months. The cumulative dose was about 104000 IR, equivalent to 4.2 mg Der p 1 and 7.3 mg Der f 1. Symptom and medication scores and respiratory function were assessed throughout the trial. Serum specific IgE and IgG4 were determined before SLIT (t0) and after 6 (t1), 11 (t2), 17 (t3), and 25 months (t4) of SLIT. Mite exposure was evaluated at t0, t2, and t4 by semiquantitative guanine determinations. Patients aged 15 years and older were asked to assess their quality of life (QoL) by completing the SF20 (Short Form Health Status Survey) plus two items at t0, t2, and t4. Use of inhaled corticosteroids and beta2-agonists was significantly decreased after 25 months of treatment in both groups (P<0.03). SLIT patients showed significant improvements in respiratory function at t4 (% predicted FEV1 (P = 0.01), VC (P = 0.002), morning (P = 0.01) and evening (P = 0.03) PEFR), and reduction in daytime asthma score (P = 0.02). In the SLIT group, the post-treatment PD20 was 1.75 times higher than the baseline value. There was no change in PD20 in the placebo group. Compared to the placebo group, the SLIT group showed a significant increase in specific IgE DP(P = 0.05), IgE DF(P = 0.02), IgG4 DP(P = 0.001), and IgG4 DF (P = 0.001) levels after SLIT. QoL scores were similar in both groups at t0 and t2. At t4, all scores were better in the SLIT group than in the placebo group, with the differences being most marked for the general perception of health (P = 0.01) and physical pain (P = 0.02). Adverse events were similar in the two groups. This study shows that SLIT in house-dust-mite-related asthma has a good safety profile and improves respiratory function, bronchial hyperreactivity, and QoL.
J Bousquet; P Scheinmann; M T Guinnepain; M Perrin-Fayolle; J Sauvaget; A B Tonnel; G Pauli; D Caillaud; R Dubost; F Leynadier; D Vervloet; D Herman; S Galvain; C André
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Allergy     Volume:  54     ISSN:  0105-4538     ISO Abbreviation:  Allergy     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-09-09     Completed Date:  1999-09-09     Revised Date:  2006-04-19    
Medline Journal Info:
Nlm Unique ID:  7804028     Medline TA:  Allergy     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  249-60     Citation Subset:  IM    
Hôpital Arnaud de Villeneuve, Service des Maladies Respiratoires, Montpellier, France.
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MeSH Terms
Administration, Sublingual
Antigens, Dermatophagoides
Asthma / immunology,  therapy*
Desensitization, Immunologic*
Double-Blind Method
Dust / adverse effects*
Glycoproteins / administration & dosage*,  immunology*
Immunoglobulin E / blood
Immunoglobulin G / blood
Quality of Life
Respiratory Function Tests
Reg. No./Substance:
0/Antigens, Dermatophagoides; 0/Dust; 0/Glycoproteins; 0/Immunoglobulin G; 37341-29-0/Immunoglobulin E

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