Procedures and adverse events for dual sublingual immunotherapy with Japanese cedar pollen and house dust mite

Abstract

In Japan, Japanese cedar pollen and house dust mite are the most common allergens causing nasal allergy. There are several studies of dual sublingual immunotherapy (SLIT) of these two antigens. In this study, we introduce the procedure of dual SLIT and frequency of adverse events (AEs).

Patients who assented to participate in this study were enrolled from October 2017 to November 2018. We used CEDARTOLEN® or CEDARCURE® as SLIT medicine for Japanese cedar pollinosis (JCP) and ACTAIR® for perennial allergic rhinitis (PAR) caused by house dust mite. In the beginning, patients received the first SLIT medicine for JCP or PAR for at least 4 weeks. When there was no severe AE, they received dual SLIT medicines. These medicines were dividedly administered in the morning and evening for at least 4 weeks. After confirming that there was no severe AEs, they received dual SLIT medicines sequentially in 5 min intervals. The selection of the first SLIT medicine was not random, but it was decided by the attending physicians and patients during consultations.

Thirty patients were enrolled this study (18 males and 12 females) aged between 17–62 years (mean 38.5 year), and the duration of observation were 3 months to 18 months (median, 7 months). Twenty-nine patients were able to continue taking dual SLIT, however, one patient discontinued because of taste dislike of the liquid medicine of JCP. Moreover, 27 patients could receive sequential dual SLIT; however, two patients dividedly received SLIT medicines due to AEs in sequential dual SLIT. AEs were detected in 60% of patients. The ratio of AEs was significantly higher in SLIT for medicines for PAR than for JCP. All of the AEs were mild.

In conclusion, dual SLIT for JCP and PAR is a safe and acceptable therapy in routine medical care.