The current role of sublingual immunotherapy in the treatment of allergic rhinitis in adults and children

Allergy/Pulmonary rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy
Journal of Asthma and Allergy 02/2011; 4(4):13-7. DOI: 10.2147/JAA.S16632
Source: PubMed


Allergic rhinitis is a very common disease affecting about 20% of people. It may be treated by allergen avoidance when possible, by antiallergic drugs such as antihistamines and topical corticosteroids, and by allergen-specific immunotherapy. The latter is the only treatment able to act on the causes and not only on the symptoms of respiratory allergy and is able to maintain its efficacy even after stopping, provided an adequate duration of treatment of 3-5 years is ensured. Sublingual immunotherapy (SLIT) was introduced in the 1990s as a possible solution to the problem of adverse systemic reactions to subcutaneous immunotherapy and has been demonstrated by more than 50 trials and globally evaluated thus far by five meta-analyses as an effective and safe treatment for allergic rhinitis. Life-threatening reactions are extremely rare. However, it is important to note that clinical efficacy occurs only if SLIT meets its needs, ie, sufficiently high doses are regularly administered for at least 3 consecutive years. This is often overlooked in the current practice and may prevent the same success reported by trials from being achieved.

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    • "It is surprising that no other study has been done in this area, either with SCIT or SLIT, that has the advantage of being much better tolerated.21 In addition, SLIT meets the requirements for use as treatment for pollen-allergic patients because it has the highest evidence of efficacy as demonstrated by meta-analyses4–8,10 and offers benefit over SCIT in terms of compliance and pharmacoeconomic aspects.22 "
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