Advancing paediatric allergy care: key findings from the largest trial of house dust mite sublingual immunotherapy-tablets in children

Allergic rhinitis and rhinoconjunctivitis (AR/C) caused by house dust mites (HDM) significantly burden children's daily lives.1 Despite allergen reduction and pharmacotherapy, many children experience substantial symptoms and impaired quality of life,2 highlighting the need for disease-modifying treatments like allergen immunotherapy (AIT). In this issue, Schuster et al.3 present compelling results from the largest double-blind, placebo-controlled trial of SQ HDM sublingual immunotherapy (SLIT)-tablets or placebo for one year in children aged 5–11 years (n = 1460) with physician-diagnosed HDM AR/C from 95 sites across Europe and North America. The primary outcome was the Total Combined Rhinitis Score during the final 8 weeks of treatment, where a 22% reduction was demonstrated with the HDM SLIT-tablet compared to placebo (absolute difference, 1.0, 95% CI: 0.5–1.4; p < 0.0001), which exceeds the minimal clinically important difference of 15%