|
SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
9/21/06
Efficacy of sublingual immunotherapy in allergic rhinitis
Summary
Background – Allergen immunotherapy by subcutaneous injection (SCIT) has been shown to induce long lasting remissions in seasonal allergic rhinitis (SAR). However, there is a potential for serious adverse systemic effects of SLIT, particularly anaphylactic reactions. The efficacy of more recently developed sub-lingual allergen immunotherapy (SLIT) approaches is less well defined because definitive evidence from large, randomized controlled trials has been lacking.
Findings – Dahl et al carried out a multi-institutional, double blind, placebo controlled trial of SLIT using a rapidly dissolving grass allergen tablet applied sublingually in 634 subjects with documented SAR for at least 2 previous years.
They found a 30% reduction in SAR symptom scores (p<0.0001) and 38% reduction in medicator scores (p<0.0001) when compared to placebo treatment. Side effects were mainly mild local itching and swelling within the mouth, leading to treatment withdrawal in only 4% of the subjects. No severe local or systemic side effects were observed.
Reference
J Allergy Clin Immunol 2006;118:434-40
Editor's Comments
The moderate reduction in SAR symptoms associated with specific SLIT treatment likely appears very significant because of the large size of the study group. It would be of great interest to see a side-by-side comparison of SLIT and SCIT in such a patient study group. In a previous comparison of SLIT (using a liquid allergen extract) and SCIT, the efficacy of SCIT was somewhat greater. However, there were systemic allergic reactions in some SCIT treated, but not SLIT treated, subjects. A detailed appraisal of SLIT was made recently by a task force of the AAAAI and the ACAAI (see JACI 2006;117:1021-35)
|