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Dermatophagoides pteronyssinus enriched allergoid, mannan-conjugated, polymerised

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About the substance

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What is Dermatophagoides pteronyssinus allergoid?

Dermatophagoides pteronyssinus enriched allergoid, mannan-conjugated, polymerised is an investigational immunotherapy product. It is an allergy vaccine made from modified proteins of the house dust mite Dermatophagoides pteronyssinus, combined with a similar allergoid from Dermatophagoides farinae, another common house dust mite species. The term "allergoid" refers to allergen proteins that have been chemically altered to reduce their ability to trigger allergic reactions while still allowing the immune system to recognise them.[3]

The product is also known as EP-088_MM09 in the trial records. It is developed by Inmunotek S.L., a Spanish pharmaceutical company. As of the registry data, it has no marketing authorisation and remains an investigational substance.[2][1]

How does Dermatophagoides pteronyssinus allergoid work?

Allergy immunotherapy works by exposing the immune system to gradually increasing amounts of the allergen in a controlled way. The goal is to shift the immune response away from the allergic pathway and toward tolerance. House dust mite allergens such as Der p 1 and Der p 2 are major triggers of allergic symptoms in sensitised individuals. By presenting modified versions of these proteins, the allergoid aims to reduce allergic reactivity without causing the full allergic response that unmodified allergens would.[3]

The mannan conjugation is intended to enhance uptake by immune cells and promote a regulatory immune response. The polymerisation step further modifies the allergen to reduce its ability to bind to IgE antibodies, which are responsible for immediate allergic reactions.[3]

Which conditions is it used or studied for?

  • Moderate-to-severe allergic rhinitis/rhinoconjunctivitis — inflammation of the nasal passages and eyes caused by house dust mite allergy, with persistent symptoms.
  • Mild-to-moderate controlled allergic asthma — asthma that is triggered by house dust mite allergy but is well controlled with standard treatment.

The trials focus on people whose symptoms are specifically caused by allergy to Dermatophagoides pteronyssinus and/or Dermatophagoides farinae.[2][1]

How is Dermatophagoides pteronyssinus allergoid given?

The product is a solution for injection given subcutaneously, meaning under the skin. In the Phase 3 trials, participants receive 0.5 ml of the vaccine at a concentration of 3,000 mTU/mL. The route of administration is subcutaneous injection.[2][1]

What do the clinical trials show?

Two Phase 3 clinical trials are authorised to evaluate this immunotherapy. Both trials share the same design and objectives. Each trial plans to enrol 250 participants, for a combined total of 500 people aged 12 to 65 years. Participants must have moderate-to-severe persistent rhinitis or rhinoconjunctivitis, with or without mild-to-moderate intermittent or persistent controlled asthma, caused by allergy to house dust mites.[2][1]

The primary outcome measure in both trials is the Rhinitis/Rhinoconjunctivitis Combined Symptom and Medication Score (RCSMS). This score combines how severe a participant's allergy symptoms are with how much medication they need to control those symptoms, recorded daily in a participant diary. The trials compare the active immunotherapy against a placebo, which is the same solution without the active ingredients.[2][1]

Both trials are currently in the authorised status, meaning they have received regulatory approval to proceed. Results are not yet available, so the efficacy and safety of this product have not been established.[2][1]

What side effects are known?

The registry records for these trials do not yet list side effects, as the studies are in the authorised stage and results have not been published. The supplementary source on house dust mite allergy does not provide specific side effect data for this investigational product.[3] As with any subcutaneous immunotherapy, local reactions at the injection site and systemic allergic reactions are possible, but no specific safety data for this product are available from the provided sources.

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