Acute Porphyria Drug Database

V01AA03 - House Dust Mites
Propably not porphyrinogenic
PNP

Rationale
House dust mite extracts consists mainly of polypeptides and proteins that are not subject to liver metabolism or interaction with CYP enzymes.
Chemical description
Allergen extract, house dust mite. Contains polypeptides and proteins.
Therapeutic characteristics
Allergen extracts containing house dust mite are used in allergy immunotherapy, to desensitize people that have an allergy to house dust mite. It is administered as a sublingual tablet (sublingual immunotherapy, SLIT). It may be used continuously for up to 3 years for long term efficacy (SPC).
Metabolism and pharmakokinetics
Upon sublingual administration allergen is presumably taken up by dendritic cells of the oral mucosa and presented to other cells of the immune system. The allergen molecules not taken up by antigen-presenting cells are believed to undergo enzymatic hydrolysis during passage through the gastrointestinal tract. There is no evidence suggesting that intact allergen enters the systemic circulation after sublingual administration and there are no reports that SLIT affects renal or hepatic function (Canonica 2016). No pharmacokinetic studies in animals or clinical studies have been conducted (EMEA, SPC).

References

  1. Scientific articles
  2. Canonica GW, Virchow JC, et al. Efficacy and safety of SQ house dust mite (HDM) SLIT-tablet treatment of HDM allergic asthma. Expert Rev Clin Immunol. 2016 Aug;12(8):805-15. PMID 27322777. #4725
  3. Government bodies
  4. EMEA. Committee for Medicinal Products for Human Use (CHMP) and Efficacy Working Party (EWP): Guideline on the clinical development of products for specific immunotherapy for the treatment of allergic diseases; EMEA/CHMP/EWP/18504/ 2006. 2008. #4797
  5. Summary of Product Characteristics
  6. Norwegian medicines agency. Summary of Product Characteristics (SPC). Acarizax. #2950

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