House dust mite immunotherapy to improve asthma control

Two trials recently have discussed this question. The first randomised double blind controlled trial looked 600 subjects who took a standardised quality house dust mite sublingual immunotherapy tablet (6 SQ-HDM) (doi:10.1016/j.jaci.2014.03.019). The inhaled corticosteroid (ICS) dose was standardised and adjusted to the lowest dose required to provide asthma control before commencing the trial medication. The primary end point was an individual reduction in ICS dose at 1 year. There was a mean difference between 6 SQ-HDM and placebo in the reduction in daily ICS dose of 81 μg (p=0.004). The second trial looked at the tolerability of house dust mite sublingual immunotherapy in asthma (doi:10.1111/all.12188). This was a randomised trial involving 454 adults with the primary outcome being stable asthma for the last 16 weeks of a 20 week trial. This occurred in 85.4% in treatment arm v 81.5% in the control arm. The post hoc analysis revealed a subgroup of 175 with moderate asthma who achieved better control (80.5% treatment v 66.1% control) and a greater mean reduction in …