TOPLINE:

In adults and adolescents with allergic rhinoconjunctivitis (ARC), sublingual immunotherapy (SLIT) with standardized extracts of house dust mite allergens reduced symptoms and medication use, improved quality of life, and demonstrated a favorable safety profile.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis of 45 studies involving 30,288 participants to evaluate the efficacy and safety of SLIT with house dust mite allergens in adults and adolescents with ARC.
• All participants received standardized house dust mite SLIT tablets or drops, and outcomes were compared with those of participants receiving placebo or pharmacotherapy.
• Key outcomes included the rhinitis symptom score (RSS), rhinitis medication score (RMS), visual analog scale score to assess symptom severity, rhinoconjunctivitis quality of life questionnaire (RQLQ) score, and incidence of adverse events, with follow-up durations ranging from 3 to 120 months.

TAKEAWAY:

• A significant reduction in the RMS was observed with SLIT vs placebo (P = .01) and SLIT vs pharmacotherapy (P < .001).
• Analysis of data pooled from 11 studies showed a significant reduction in the RSS with SLIT vs placebo (P < .001).
• A pooled analysis showed that SLIT led to significant reductions in visual analog scale scores compared with placebo and pharmacotherapy (P < .001 for both). Additionally, the analysis showed that SLIT significantly improved RQLQ scores compared with placebo (P < .001).
• No statistical difference was observed in the risk of developing serious adverse events with SLIT vs placebo or pharmacotherapy.

IN PRACTICE:

“[The] findings strongly support the use of HDM [house dust mite] SLIT as a foundational, disease-modifying therapy in the management of house dust mite-induced allergic rhinoconjunctivitis,” the authors of the study wrote. 

SOURCE:

Abdulsalam Alqutub, Department of Otorhinolaryngology-Head and Neck Surgery, Makkah Health Cluster, Makkah, Saudi Arabia, was the corresponding author of the study, which was published online on February 27, 2026, in the International Archives of Allergy and Immunology.

LIMITATIONS:

The analysis showed notable heterogeneity in several outcomes (particularly RSS and RMS), driven by differences in study design, populations, formulations (tablets vs drops and varying potency units), and geographic settings, possibly limiting direct comparability. Nine randomized controlled trials had a high risk for bias, potentially affecting pooled estimates.

DISCLOSURES:

The authors reported having no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.