Sublingual desensitization to mites could develop with tablets. They alleviate the complications of asthma.
“Clean, sweep, polish. This is the daily life of many people with dust mite allergies. Half of people with asthma suffer from this immune reaction. One tablet daily could prevent their seizures from getting worse from these microscopic arachnids. This is shown by a clinical trial partly conducted in France and published in the Journal of the American Medical Association (JAMA) as World Asthma Day takes place this Tuesday.
Treatments not always effective
In people with asthma, the presence of an allergy favors the sudden worsening of the disease, known as an exacerbation. It also significantly worsens symptoms. Faced with this, two drug options of moderate efficacy since asthma is unstable in 30% of cases. The most sustainable approach remains desensitization, used for twenty years in France.
In this clinical trial, the researchers brought together 834 adults who were diagnosed with house dust mite allergy and who suffered from asthma. They were separated into three groups, two serving to test two different doses of immunotherapy and one serving as a control. If the most severe forms of asthma were excluded, because of the risk, the team wanted to select patients with varied profiles.
“We chose a population that follows long-term treatment, whose asthma is not well controlled thanks to this treatment,” explains Frédéric De Blay, investigator and co-author of the study. Desensitization enabled them, when corticosteroids were reduced, to reduce the onset of exacerbations. “
Frédéric De Blay, head of the thoracic pathology center (Strasbourg University Hospital): ” The old recommendations say that asthma must be mild to consider desensitization. We placed ourselves in a more severe population. “
Less worsening of asthma
During the year of follow-up, the researchers reduced the corticosteroid therapy by 50% and then completely stopped the treatment after three months. This technique has reduced the risk of worsening asthma by 30%. The use of inhaled corticosteroids, indicated for asthma attacks, fell by the same proportion.
“People who had always taken inhaled corticosteroids no longer took them, including some of my patients,” says Frédéric De Blay. The appearance of the first exacerbations, which are manifested by taking medication, by discomfort for several days, occurred less frequently in the desensitized group than in the placebo group. “
98% sublingual desensitization
The approach is all the more interesting as it causes relatively few side effects. The most frequent consisted of a moderate itching in the mouth, that is to say itching related to the allergy where the tablet was deposited. Swelling of the mouth and throat irritation have also been reported.
Frédéric De Blay : ” You can imagine that taking tablets is easier than giving injections to the doctor. It is also much better supported. “
Today, 98% of desensitizations are carried out sublingually, but in the form of drops. Only one tablet is authorized in France, against grass pollens. It remains less well reimbursed than the other approaches. But for Frédéric De Blay, this desensitization is a way of the future. “Studies have started on desensitization to birch pollen. We can also consider an evaluation against ragweed pollen or cat allergen, he believes. I think this is one of the avenues of interest for desensitization. There may be more, but this is the most advanced, and it is showing results. “
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