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Sublingual Immunotherapy May Improve Allergy Symptoms, but Questions Remain — Physician’s First Watch

Medical News |
March 27, 2013

Sublingual Immunotherapy May Improve Allergy Symptoms, but Questions Remain

By Amy Orciari Herman

Sublingual immunotherapy may improve outcomes in patients with allergic rhinitis and asthma, according to a systematic review in JAMA. The treatment is approved in Europe but not the U.S., although some U.S. physicians use it off-label to desensitize patients to allergens.

Researchers examined 63 randomized trials that tested aqueous sublingual immunotherapy in over 5000 children and adults with confirmed allergic rhinitis, rhinoconjunctivitis, or asthma. Common allergens included grass and dust mites.

The researchers found strong evidence that the treatment improved asthma symptoms and moderate evidence that it improved rhinitis and rhinoconjunctivitis symptoms. Data on safety were insufficient, but no life-threatening adverse events were reported.

An editorialist concludes: "Although patients may prefer a therapy that is relatively safe and can be administered at home, FDA approval has not been granted yet, and many unanswered questions remain about the use of sublingual immunotherapy." Such questions include those surrounding optimal dosing and duration of use.

Reader Comments (2)

Elizabeth Parada Physician, Allergy/Immunology, hospital Luis Rezetti

quisiera tener el texto completo del articulo

Martha H Howard, MD

In the face of "strong evidence" of sublingual immunotherapy's reduction of asthma symptoms, patient preference, and approval in the E.U. we are still questioning it? We are still stuck in our practice of administering shots in the office? Why? Are we afraid of losing a cash cow? This is a perfect example of why our medical system comes in last of all the developed countries.

Competing interests: None declared

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