Long-Term Efficacy of Sublingual Immunotherapy in Patients With Perennial Rhinitis

Istanbul University, İstanbul, Istanbul, Turkey
The Laryngoscope (Impact Factor: 2.14). 07/2007; 117(6):965-9. DOI: 10.1097/MLG.0b013e31804f8141
Source: PubMed


Sublingual immunotherapy has a documented clinical efficacy, but only a few long-term studies have been performed in people with perennial rhinitis.
The purpose of this study was to evaluate the long-term efficacy of sublingual immunotherapy.
One hundred thirty-seven patients with allergies to house dust mites were treated with sublingual house dust-mite-specific immunotherapy for 2 or 3 years and were also observed for 3 years after discontinuation of the treatment. The patients were divided into 2 groups: group A (67 patients) received active treatment for 2 years and then 1 year for placebo, and group B (70 patients) received active treatment for 3 years. The success of the treatment was evaluated with the symptom score, skin prick test results, and the nasal allergen challenge score.
According to our study results, we found a greater improvement in the 3 years of sublingual immunotherapy compared with the 2 years of sublingual immunotherapy when we looked at the comparative results of the total 6 years.
We suggest 3 years of sublingual immunotherapy for patients with perennial allergic rhinitis who require immunotherapy and do not accept the subcutaneous route of allergen administration.

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    • "The maintaining effects after discontinuation of SLIT has not yet been fully established although those of SCIT has been acknowledged [39]. A study including 137 patients with HDM AR showed that a greater improvement in the 3 years of SLIT compared with the 2 years of SLIT [40]. In another study with 15 years observation including mono-sensitized patients to HDM, clinical benefits of SLIT persisted for 7 years in patients with 3-year SLIT and for 8 years in those with 4, 5-year SLIT [41]. "
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    ABSTRACT: Current treatment options for allergic rhinitis (AR) include allergen avoidance and environmental control, pharmacotherapy, nasal surgery and immunotherapy. Among these, immunotherapy is the only therapeutic option that modifies fundamental immunologic mechanism by inducing desensitization. Specific allergen immunotherapy has been used for 1 century since 1911 and subcutaneous immunotherapy (SCIT) has been demonstrated to be effective in asthma and AR. However, SCIT has several disadvantages such as inconvenience, invasiveness and potentially severe systemic reactions. Thus, sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment for AR and is now widely used to replace the subcutaneous route. SLIT has recently been introduced in Korea and is now available for AR treatment in the Asia-Pacific region. This review offers better understanding of SLIT for AR by summarizing published articles and our previous works regarding proposed mechanisms, indication and efficacy, safety and adverse events, and compliance.
    10/2011; 1(3):123-9. DOI:10.5415/apallergy.2011.1.3.123
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    • "All patients were followed up for 3 years after stopping the treatment. A greater improvement of symptoms was found in the patients treated for 3 years.37 In a prospective open controlled study, patients monosensitized to mites were divided into four groups, one receiving only drug treatment and the other three receiving SLIT for 3, 4, or 5 years. "
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    ABSTRACT: 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.
    Journal of Asthma and Allergy 02/2011; 4(4):13-7. DOI:10.2147/JAA.S16632
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