Three-year sublingual immunotherapy for HDM-induced allergic rhinoconjunctivitis: sustained ocular symptom improvement.

BACKGROUND

Allergic conjunctivitis (AC) frequently coexists with allergic rhinitis (AR), together known as allergic rhinoconjunctivitis (ARC), but ocular symptoms are often underemphasized in efficacy assessments using composite scores. Therefore, this study aimed to isolate and quantify the therapeutic effect of house dust mite sublingual immunotherapy (HDM-SLIT) on ocular symptoms, providing targeted evidence for managing AC in HDM-sensitized patients.

METHODS

The complete clinical data of 150 patients with ARC aged 6-59 years who started HDM-SLIT for 3 years between March 2020 and May 2022 were retrospectively analyzed. The level of the total nasal symptom score (TNSS), total ocular symptom score (TOSS), total medication score (TMS), combined score of medication and rhinoconjunctivitis symptoms (CSMRS), the visual analog scale (VAS) score, and rhinoconjunctivitis quality of life questionnaire (RQLQ) were evaluated at baseline, 1, 2, and 3 years of treatment. Additionally, the occurrence of adverse events (AEs) was used to evaluate its safety.

RESULTS

Compared with baseline, significant improvements in TNSS, TOSS, TMS, CSMRS, and VAS scores were observed after 1, 2, and 3 years of SLIT (all p < 0.001). Compared with 1-year results, TNSS, CSMRS, and VAS scores showed further improvements at 2 and 3 years (all p < 0.001). RQLQ scores improved significantly across all domains and age groups (6-11 years, 12-17 years, and ≥18 years groups) at all time points (all p < 0.001). Subgroup analysis revealed no significant difference in efficacy between the children and adult groups. Throughout the 3-year treatment period, no serious systemic AEs were reported.

CONCLUSION

Three-year HDM-SLIT yields significant, sustained, and progressive improvements in clinical outcomes and quality of life in patients with ARC, along with significant improvements in ocular symptoms and a favorable safety profile.