{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:31:52Z","timestamp":1787056312972,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Inmunotek S.L."},{"id":[{"id":"https:\/\/ror.org\/01e2spe61","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Allergic rhinoconjunctivitis (AR) induced by house dust mites (HDMs) is a common condition that impairs quality of life, and allergen immunotherapy is the only treatment accepted to modify its natural course. However, real-world evidence on polymerized HDM subcutaneous immunotherapy (SCIT) remains limited. We evaluated the up to 24-month effectiveness of polymerized HDM SCIT and examined how baseline symptom burden affects the measured response. Methods: In a retrospective, single-arm, real-world cohort, 353 patients (mean age 15.9 (12.3) years) with HDM-induced AR with\/without asthma (asthma subpopulation, n = 112) initiated polymerized SCIT (ALXOID\u00ae, Inmunotek S.L., Spain) with an extract of house dust mites (Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis). Patients were followed for up to 24 months; 139 contributed an observation at month 12 and 67 at month 24. The primary outcome was the Rhinoconjunctivitis Combined Symptom\u2013Medication Score (RCSMS); secondary outcomes were a visual analog scale (VAS) and the ESPRINT-15 quality-of-life questionnaire. Effectiveness was estimated using mixed models for repeated measures. The pre-specified primary-analysis population was restricted to a baseline RCSMS \u2265 2 to avoid floor effects and regression to the mean at low baseline scores. Results: At month 24, the RCSMS decreased by 0.938 points (\u221235.3%) in the full cohort and by 48.3% in the baseline RCSMS \u2265 2 population; in the full cohort, the VAS and ESPRINT-15 improved by 50.6% and 69.7%, respectively (all p &lt; 0.001; within-subject effect sizes were small for the full-cohort RCSMS and medium for all other outcomes). The shape of the improvement trajectory did not differ by age group, and all age groups exceeded the minimal clinically important difference; the age analysis was exploratory. Patients with baseline RCSMS &lt; 2 showed continued improvement in VAS and ESPRINT-15 scores. In contrast, the RCSMS increased, a pattern consistent with a statistical floor effect, suggesting limited responsiveness of the score at low baseline values. Conclusions: Up to 24 months, polymerized HDM SCIT was associated with clinically meaningful improvements in symptoms, medication use, and quality of life, most clearly in patients with a baseline RCSMS \u2265 2. Baseline symptom severity should be considered when interpreting combined symptom\u2013medication outcomes in allergen immunotherapy. The single-arm design precludes causal inference.<\/jats:p>","DOI":"10.3390\/jcm15166383","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:09:32Z","timestamp":1787054972000},"page":"6383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Effectiveness of Polymerized House-Dust-Mite Subcutaneous Immunotherapy up to 24 Months: Why Baseline Symptom Severity Shapes Measurement of the Combined Symptom\u2013Medication Response"],"prefix":"10.3390","volume":"15","author":[{"given":"Margarita Rosa","family":"Acevedo Matos","sequence":"first","affiliation":[{"name":"AlergoIPS, Pereira 660003, Risaralda, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Francisco","family":"Sierra Salgado","sequence":"additional","affiliation":[{"name":"AlergoIPS, Pereira 660003, Risaralda, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenny Alexandra","family":"Mendez","sequence":"additional","affiliation":[{"name":"AlergoIPS, Pereira 660003, Risaralda, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5205-4105","authenticated-orcid":false,"given":"Sandra","family":"del Pozo","sequence":"additional","affiliation":[{"name":"Inmunotek S.L., 28805 Alcal\u00e1 de Henares, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-3963","authenticated-orcid":false,"given":"Miguel","family":"Casanovas","sequence":"additional","affiliation":[{"name":"Inmunotek S.L., 28805 Alcal\u00e1 de Henares, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.jaci.2018.08.049","article-title":"Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018)","volume":"143","author":"Bousquet","year":"2019","journal-title":"J. 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