Clinical efficacy and compliance of sublingual immunotherapy with Dermatophagoides farinae drops in patients with atopic dermatitis

Background The oral route for administration of allergen immunotherapy has been explored since the 1900s. We attempted to evaluate the efficacy and safety of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in patients with atopic dermatitis (AD) and investigate related factors influencing the patients' compliance. Methods A total of 107 patients with AD were randomized to receive either D.farinae drops plus pharmacotherapy (treatment group, n=58) or only pharmacotherapy (control group, n=49). Patients' compliance, the total effective rate, daily drug scores, visual analogue scale (VAS) scores, and IgG4 level were compared respectively between two groups at different time points. Results Twenty-three cases have withdrawn from the study. The total effective rate in the treatment group (77.78%) was significantly higher than the control group (53.85%) (P<0.05). The treatment group was significantly reduced in daily drug scores and VAS scores compared with the control group at 12months follow-up. Meanwhile, at the end of therapy, a significant difference was found in the change in average daily drug scores (difference from 1 month) between two groups (P<0.01); The treatment group evidently had a higher level of serum-specific IgG4 than the control group at 6 and 12month of treatment (P<0.05). Conclusion Dermatophagoides farinae drops are a safe and effective SLIT for patients with AD, which was proven to reduce the need for medicine. In addition, SLIT could induce a tolerogenic IgG4 response to mite allergen correlated with favorable clinical efficacy. Standardization of specific immunotherapy is essential to ensure therapeutic efficacy and compliance.