House dust mite immunotherapy reduces IgE and symptoms in Indonesian children with allergic rhinitis and asthma
Photo by Vitaly Gariev / Unsplash
Key Takeaway
Consider preliminary RCT data showing HDM SCIT reduced IgE and symptoms in a small Indonesian pediatric cohort.
A randomized controlled trial in Indonesia enrolled 41 children with allergic rhinitis and asthma to evaluate weekly subcutaneous immunotherapy with house dust mite extract over 14 weeks, with 3.2 months of follow-up. The comparator was not reported. The intervention significantly reduced total IgE (p < 0.05), TGF-β1 (p < 0.05), the Combined Symptom Medication Score (p < 0.05), and Visual Analogue Scale scores (p < 0.05). Specific IgE showed a non-significant downward trend, and IL-10 showed a slight, non-significant increase (p = 0.683). No significant differences in treatment effect were found between children with allergic rhinitis alone versus those with both allergic rhinitis and asthma (p > 0.05).
Safety and tolerability data, including adverse events and discontinuations, were not reported in the available evidence. The authors note that local pediatric evidence for this intervention remains limited.
Key limitations include the small sample size of 41 patients, the lack of reported primary outcome and comparator details, and the absence of absolute numbers or effect sizes for the reported changes. The findings represent preliminary evidence from a specific population. For clinicians, this small RCT suggests HDM subcutaneous immunotherapy may be associated with reduced immunological markers and symptom burden in Indonesian children with allergic rhinitis and asthma, but the evidence is too limited to guide practice without further confirmation.
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View Original Abstract ↓
BACKGROUND: Allergic rhinitis (AR) and asthma due to house dust mite (HDM) are increasing in children worldwide, including Indonesia, where the tropical environment favors HDM proliferation. Although Subcutaneous immunotherapy (SCIT) is widely used, local pediatric evidence remains limited.
OBJECTIVE: To evaluate the effect of HDM SCIT on clinical and immunological outcomes in children with AR and AR plus asthma.
METHODS: A double-blind randomized controlled trial was conducted in 41 children, divided into AR (n = 20) and AR + asthma (n = 21) groups. Participants received weekly HDM SCIT for 14 weeks. Total IgE, specific IgE, IL-10, TGF-β1, Combined Symptom Medication Score (CSMS), and Visual Analogue Scale (VAS) were measured before and after treatment. Statistical analyses included paired t-test, Wilcoxon, independent t-test, and Mann-Whitney, with significance at p < 0.05.
RESULTS: HDM SCIT significantly reduced total IgE, TGF-β1, CSMS, and VAS (p < 0.05). Specific IgE showed a downward trend without statistical significance. IL-10 levels slightly increased but were not significant (p = 0.683). No significant differences in treatment effect were observed between AR and AR + asthma groups (p > 0.05).
CONCLUSION: HDM SCIT improved clinical outcomes and reduced key immunological markers in children with AR and AR plus asthma, though no intergroup differences were found. These findings provide preliminary evidence supporting HDM SCIT as a safe and beneficial adjunct therapy in Indonesian pediatric populations.
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