EAACI Allergy Immunotherapy Clinical Practice Guidelines

European Academy of Allergy and Clinical Immunology has published Guidelines for the use of house dust mites (HDM) allergy immunotherapy (AIT) as add on for HDM‐driven allergic asthma

Allergen immunotherapy (AIT) has been in use for the treatment of allergic disease for more than 100 years. Asthma treatment relies mainly on corticosteroids and other controllers recommended to achieve and maintain asthma control, prevent exacerbations, and improve quality of life. AIT is underused in asthma, both in children and in adults

Bronchial asthma is a clinical syndrome which is characterized by episodic reversible airway obstruction, increased bronchial reactivity, and airway inflammation. Asthma results from complex interactions among inflammatory cells, their mediators, airway epithelium and smooth muscle, and the nervous system. In genetically susceptible individuals, these interactions can lead the patient with asthma to symptoms of breathlessness, wheezing, cough, and chest tightness.

Major recommendations are-

• House dust mite (HDM) subcutaneous immunotherapy (SCIT) is recommended for children and adults with controlled HDM‐driven allergic asthma as an add‐on treatment to regular therapy to decrease symptoms and medication use.


• HDM SCIT is recommended for adults with controlled HDM‐driven allergic asthma as the add‐on treatment to regular therapy to decrease allergen‐specific airway hypersensitivity and to improve quality of life.


• HDM sublingual immunotherapy (SLIT) drops are recommended for children with controlled HDM‐driven allergic asthma as an add‐on treatment to decrease symptoms and medication use.


• HDM SLIT‐tablets are recommended for adults with controlled and partially controlled HDM‐driven allergic asthma as an add‐on treatment to regular therapy to decrease exacerbations and to improve asthma control.