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The National Institute for Health and Care Excellence (NICE) has recommended the first daily treatment option for persistent moderate-to-severe house dust mite allergic rhinitis, which “could benefit around 13,000 people”.
In final draft guidance published on 30 January 2025, NICE recommended the treatment 12 SQ-HDM SLIT (Acarizax; ALK-Abello) for people aged 12–65 years.
This first-of-its-kind treatment works by giving a regular fixed amount of house dust mite allergy extract every day over three years. This increases the body’s resistance to house dust mites, so it can become less sensitive to their effect, reducing the symptoms of the allergic reaction over time.
The treatment is recommended for patients who have been diagnosed through their clinical history and had a positive test of their house dust mite allergy through either a skin prick test or specific immunoglobulin E test.
In a statement, NICE said results from clinical trials have shown the treatment to be “particularly beneficial for those whose symptoms cannot be managed by standard treatments, such as steroid nasal sprays and antihistamines”.
Helen Knight, director of medicines evaluation at NICE, said the treatment “has potential to be truly life-changing”.
“For people with house dust mite allergic rhinitis that is not controlled by standard treatments, this new cost-effective drug will have a significant positive impact on their quality of life,” she added.
Common symptoms of allergic rhinitis include sneezing, an itchy nose, a runny or blocked nose and itchy, red and watery eyes.
However, in severe cases, the condition can be debilitating and cause facial swelling, fatigue and affect a person’s sleep.
It is classified as persistent if the symptoms are present for four or more days per week for a month and have not been resolved by standard treatments.
Amena Warner, head of clinical services at Allergy UK, said the recommendation of 12 SQ-HDM SLIT is “a landmark step” for people who fit the criteria to be able to access this through the NHS.
“Many endure years of misery, of nasal congestion, loss of smell and sneezing, impacting their sleep and daily living with little respite from symptoms. This can also affect mental wellbeing. With this treatment, there is now hope for people who fit the criteria to be able to access this through the NHS,” she added.
“Although initial access to a specialist allergy service will mainly be required to commence treatment, importantly, it can be continued as a home treatment, without the need for frequent hospital visits, which incur travel and time costs. The patient benefit will be far-reaching, and we welcome this decision.”
NICE said the treatment will be available on the NHS in England within three months of its final guidance being published.
