Ragweed Sublingual Tablet Immunotherapy: Part II – Practical Considerations and Pertinent Issues

Abstract

Sublingual allergen immunotherapy (SLIT) has been demonstrated to be both efficacious and safe for the treatment of respiratory allergies such as allergic rhinoconjunctivitis or allergic asthma. Based on the clinical documentation of SLIT ragweed tablets, they have gained marketing authorization in the USA by the US FDA in 2014 for adult patients. Following clinical data from (pivotal) multicenter Phase II and III trials as performed in the USA and Canada and real life experience after registration in 2014, SLIT ragweed tablets can be recommended as efficacious and safe treatment option with disease modifying potential when adequately indicated and performed. Therefore, several practical issues should be considered for treating ragweed allergic patients with these tablets. This second part of a thorough review on ragweed SLIT tablets addresses important clinical questions which should be taken into account by the subscribing practitioner before initiation and during the treatment.

Keywords::

• allergen immunotherapy
• practical considerations
• ragweed
• SLIT
• tablet

Financial & competing interests disclosure

O Pfaar reports grants and personal fees from ALK-Abelló, grants and personal fees from Allergopharma, grants and personal fees from Stallergenes Greer, grants and personal fees from HAL Allergy Holding B.V./HAL Allergie GmbH, grants and personal fees from Bencard Allergie GmbH/Allergy Therapeutics, grants and personal fees from Lofarma, grants from Biomay, grants from Nuvo, grants from Circassia, grants and personal fees from Biotech Tools S.A., grants and personal fees from Laboratorios LETI/LETI Pharma, personal fees from Novartis Pharma, personal fees from MEDA Pharma, grants and personal fees from Anergis S.A., personal fees from Sanofi US Services, personal fees from Mobile Chamber Experts (a GA2LEN Partner), personal fees from Pohl-Boskamp, personal fees from Indoor Biotechnologies, outside the submitted work. PS Creticos has received research grant funding from Circassia, Merck, and Stallergenes-Greer; has served as a consultant to Allergy Therapeutics, Anergis, ASIT, Circassia, OptiNose, and Stallergenes-Greer; has served as a speaker for Merck; is an editor and author for UpToDate; receives royalties from UpToDate; has received payment for development of educational presentations from WebMD, Elsevier, and the AAAAI; has served on advisory panels for NIAID, PCORI and AHRQ; and serves on committees of the AAAAI and ACAAI. 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.

Notes

SLIT: Sublingual allergen immunotherapy.

Modified with permissions from [18] and [33].

Additional information

Funding

O Pfaar reports grants and personal fees from ALK-Abelló, grants and personal fees from Allergopharma, grants and personal fees from Stallergenes Greer, grants and personal fees from HAL Allergy Holding B.V./HAL Allergie GmbH, grants and personal fees from Bencard Allergie GmbH/Allergy Therapeutics, grants and personal fees from Lofarma, grants from Biomay, grants from Nuvo, grants from Circassia, grants and personal fees from Biotech Tools S.A., grants and personal fees from Laboratorios LETI/LETI Pharma, personal fees from Novartis Pharma, personal fees from MEDA Pharma, grants and personal fees from Anergis S.A., personal fees from Sanofi US Services, personal fees from Mobile Chamber Experts (a GA2LEN Partner), personal fees from Pohl-Boskamp, personal fees from Indoor Biotechnologies, outside the submitted work. PS Creticos has received research grant funding from Circassia, Merck, and Stallergenes-Greer; has served as a consultant to Allergy Therapeutics, Anergis, ASIT, Circassia, OptiNose, and Stallergenes-Greer; has served as a speaker for Merck; is an editor and author for UpToDate; receives royalties from UpToDate; has received payment for development of educational presentations from WebMD, Elsevier, and the AAAAI; has served on advisory panels for NIAID, PCORI and AHRQ; and serves on committees of the AAAAI and ACAAI. 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.