Sublingual allergen immunotherapy for respiratory allergies: what is new?

Abstract

Sublingual immunotherapy (SLIT) is a disease-modifying treatment for respiratory allergies that has been used for many years in Europe and has also recently been approved for use in North America. Its use is thus likely to increase. There is more evidence available regarding SLIT efficacy and its good safety profile, making it an appealing treatment option. The majority of studies have mostly focused on grass pollens; however, there are now data available regarding efficacy for other allergens. This review will summarize recent findings from SLIT clinical trials for respiratory allergies, including efficacy, safety, post-discontinuation effects and use in different age groups. Grass pollen, tree pollen, house dust mite and ragweed SLIT studies will be evaluated.

Keywords::

• allergen immunotherapy
• allergic rhinoconjunctivitis
• grass pollen
• house dust mite
• ragweed
• sublingual immunotherapy
• tree pollen

Financial & competing interests disclosure

MA Calderon has received consultancy fees and speaker’s honoraria from ALK, Stallergenes, HAL-Allergy, Merck and Allergopharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Grass sublingual immunotherapy (SLIT) appears to be effective in polysensitized grass-allergic individuals as well as in grass monosensitized individuals.

• Treatment with grass SLIT leads to sustained efficacy post discontinuation of treatment.

• Presence of asthma and sensitization status does not appear to affect the efficacy results of house dust mite SLIT.

• SLIT is well tolerated with mild and local reactions being most frequent and only very low rates of systemic reactions.