BOLETÍN BIBLIOGRÁFICO
DE INMUNOTERAPIA
Artículo destacado – Noviembre 2021
1
ITA con ácaros en dermatitis atópica: ¿sí o no?
Efficacy of House Dust Mite Sublingual Immunotherapy in Patients with Atopic Dermatitis: A Randomized, Double-blind, Placebocontrolled Trial.
Langer SS, Cardili RN, Melo JML, Ferriani MPL, Moreno AS, Dias MM, et al
J Allergy Clin Immunol Pract. 2021 Nov 9:S2213-2198(21)01250-2. doi: 10.1016/j.jaip.2021.10.060. Epub ahead of print
BACKGROUND
Sensitization to house dust mites (HDM) is frequent in patients with atopic dermatitis (AD).
OBJECTIVE
To investigate the efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides pteronyssinus(Dpt) extract in patients with AD sensitized to HDM.
METHODS
In this randomized, double-blind, placebo-controlled trial, we enrolled 91 patients aged ≥3 years, with SCORing Atopic Dermatitis (SCORAD) ≥15 and positive skin test and/or IgE to Dpt. Patients were stratified according to age (15-point decrease in SCORAD. Secondary outcomes were decreases in SCORAD and objective SCORAD (O-SCORAD), Eczema Area and Severity Index (EASI), visual analog scale (VAS) for symptoms, pruritus scale; Investigator's Global Assessment (IGA) 0/1; and decrease ≥4 points in Dermatology Life Quality Index (DLQI). Background therapy was maintained.
RESULTS
A total of 66 patients completed the study (35 HDM SLIT, 31 placebo). After 18 months, 74.2% and 58% patients in HDM SLIT and placebo groups, respectively, showed >15-point decrease in SCORAD (relative risk[RR]1.28, 95% confidence interval[CI] 0.89-1.83). Significant SCORAD decreases from baseline of 55.6% and 34.5% in HDM SLIT and placebo groups (mean difference 20.4;95%CI 3.89-37.3); significant O-SCORAD decreases of 56.8% and 34.9% in HDM SLIT and placebo groups (mean difference 21.3;95%CI 0.66-41.81); and more patients with IGA 0/1 in HDM SLIT group as compared to placebo group (14/35 vs 5/31;RR 2.63, 95%CI 1.09-6.39), were observed at 18 months.
CONCLUSION
Our results suggest that HDM SLIT may be effective in HDM sensitized patients as an add-on treatment for AD.