Efficacy of individual increment on house dust mite sublingual immunotherapy in low-response patients with allergic rhinitis

This study aimed to investigate the clinical improvement of the incremental dosage regimen in allergic rhinitis (AR) patients with low response to sublingual immunotherapy (SLIT). This retrospective study included 65 AR patients with low response to dust mite SLIT after 6-month treatment. Patients were divided into regular-dose (RD) group (n = 23) and high-dose (HD) group (n = 42). The RD group maintained the previous standard dose, while the HD group received the higher tolerated dose and further categorized into 2 subgroups based on increased doses. Total nasal symptoms score (TNSS), total medication score (TMS), combined symptom and medication score (CSMS), and visual analog scale were compared at baseline, 6 months, and 1 year. Safety was assessed by reported adverse events (AEs).There were no significant differences between RD and HD groups at baseline and 6 months. However, patients in the HD group showed significantly lower TNSS, TMS, CSMS, and visual analog scale at 1 year compared to the RD group (all P <.01). Continued improvements in TNSS, TMS, and CSMS were only found in the HD group from 6-month to 1-year treatment (all P <.01). Moreover, there was no statistical difference between HD subgroups at any follow-up points. In addition, a higher proportion of patients in the HD group discontinued medication. No difference was observed in AEs between RD and HD groups. Dose increment after 6-month SLIT treatment could significantly enhance efficacy in low-response AR patients over a 1-year course without raising the risk of AEs.