Efficacy and safety of house dust mite cluster immunotherapy in the treatment of allergic rhinitis and asthma: a multicenter prospective single-arm interventional study

Objective To investigate the efficacy and safety of 4-week cluster immunotherapy with house dust mite extracts in patients allergic to house dust mites. Methods From August 2022 to May 2024， 80 patients with house dust mite-induced allergic rhinitis， complicated with or without asthma， were recruited from multiple centers （including Peking Union Medical College， et al） to undergo 4-week dose-escalation subcutaneous cluster immunotherapy with house dust mites. Patient symptoms， medication use， quality of life， asthma control test （ACT） results， as well as local and systemic adverse reactions were recorded at 0， 1， 6， and 12 months， respectively. Results Significant differences were observed in the daily total symptom scores （<i>P &lt; </i>0.001）， daily nasal scores （<i>P &lt; </i>0.001）， daily ocular scores （<i>P = </i>0.009）， and total symptom and medication scores （<i>P = </i>0.003） across different time points during cluster immunotherapy， respectively. Significant differences were also found in the activity RQLQ （<i>P &lt; </i>0.001）， sleep RQLQ （<i>P = </i>0.002）， non-eye/nose symptom RQLQ （<i>P = </i>0.032）， practical problems RQLQ （<i>P &lt; </i>0.001）， nasal symptom RQLQ （<i>P &lt; </i>0.001）， emotional RQLQ （<i>P = </i>0.011）， total RQLQ （<i>P &lt; </i>0.001）， and children’s ACT scores （<i>P &lt; </i>0.001）， respectively. The longer the time， the lower the score. During the dose-escalation period， 22 patients （27.5%） experienced local adverse reactions， and 5 patients （6.3%） experienced systemic adverse reactions. A total of 35 （3.6%） injections resulted in adverse reactions， including 27 （2.8%） injections with local reactions and 8 （0.8%） injections with systemic reactions. Conclusion Four-week cluster immunotherapy with house dust mites shows significant efficacy in patients allergic to house dust mites.