Los Angeles Allergist

Los Angeles Allergist

Alan Khadavi, MD, APC
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9001 Wilshire Blvd. Suite 204
Beverly Hills, CA 90211
Phone: 310-282-8822

16260 Ventura Blvd., Suite 140
Encino, CA 91436
Phone: 818-528-7776

December 29, 2016 by Alan Khadavi

Sublingual Dust Mite Immunotherapy

Sublingual dust mite immunotherapy tablets are currently being developed by Merck.  House dust mite is the most common cause of perennial allergic rhinitis worldwide.  Symptoms of house dust mite allergies can be treated with medications or allergy immunotherapy, currently available in the shot form or sublingual drops.  The sublingual drops have shown good efficacy is it can alter the immune response to modify the pathologic mechanisms of allergic rhinitis and conjunctivitis for years.

Sublingual dust mite tablets manufactured by Merck contain the 2 major house dust mite allergens, Dermatophagoides pteronyssinus and Dermatophagoides farinae mite species.  In European trials, the sublingual dust mite tablets were well tolerated in subjects 5 years of age and older and improved nasal and ocular symptoms in trials.  The sublingual dust mite tablets also demonstrated beneficial effects on asthma outcomes.

Nearly one third of the US population is sensitized to house dust mites.  A study published in the Journal of Allergy and Clinical Immunology, December 2016, evaluated the efficacy and safety of the sublingual dust mite tablets in patients with dust mite allergies in North American subjects.

The results demonstrated a significant improvement in sublingual dust mite tablet group versus placebo.  Furthermore, 31% of the subjects had a a history of asthma and asthma symptoms improved over placebo.  The trial was powered to meet the the US FDA criteria for efficacy as Merck is trying to get this approved for mass use in the United States.

The sublingual dust mite tablets were also well tolerated with side effects being minimal in the treatment group.  Common side effects were throat irritation, oral itching and ear itching.  1 patient to be treated with epinephrine for a systemic allergic reaction.

In our practice, we currently use sublingual dust mite drops to treat our patients with dust mite allergy who do not want to do the allergy shots.  We have seen very good results as well.  When the tablets become available, they will most likely be covered by insurance companies with a high copay.

There is no current time frame when the dust mite tablets will be available, so if you suffer from dust mite allergies, speak to your allergy doctor about what the best current options are available for you right now.

The current tablets currently available are;

Ragweed Tablet approved

Oralair first approved Sublingual Grass Extract

Filed Under: Blog, Immunotherapy

alan-khadavi
Dr. Alan Khadavi
Allergy & Asthma Specialist

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