A novel approach in allergen-specific immunotherapy: Combination of sublingual and subcutaneous routes

Keleş, Sevgi; Karakoç-Aydıner, Elif; Özen, Ahmet; Izgi, Ayse Gul; Tevetoğlu, Ayzer; Akkoç, Tunç; Bahceciler, Nerin N.; Barlan, Işıl

doi:10.1016/j.jaci.2011.04.033

Cited by 111 publications

(75 citation statements)

References 26 publications

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“…Likewise, those two groups proved efficacious in terms of decreasing symptom and medication scores for asthma starting from month 4 and rhinitis at month 12, with SCIT plus SLIT even more effective than SCIT for rhinitis ( Table 4). The sublingual route proved safer than the subcutaneous because no patients receiving SLIT experienced significant adverse reactions, whereas two patients receiving SCIT had to discontinue treatment because of side effects [177]. Antunez et al [178] compared SLIT vs. SCIT over a 2-year period in children with respiratory disease monosensitized to Dermatophagoides pteronyssinus.…”

Section: Pediatric Populationsmentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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Asthma is frequently associated with atopy, characterized by the production of specific immunoglobulin E in response to environmental allergens. Currently, two types of allergen immunotherapy (AIT) are used in clinical practice: subcutaneous and sublingual immunotherapy, both accepted as key components of the therapeutic repertoire for allergic rhinitis and conjunctivitis. However, their role in asthma remains controversial. The present document is aimed at providing the clinicians with a review of the evidence on the use of AIT in asthma, focusing on the most relevant aspects of its mechanism of action, its efficacy, and existing data on safety, tolerability, and cost-effectivity, both in pediatric and adult populations. A systematic search of MEDLINE, Cochrane, and Clinical Trials databases from 2000 to April of 2016 was carried out by a panel of experts from the Spanish Allergy and Clinical Immunology Scientific Society. Relevant studies prior to the year 2000 included in ulterior systematic reviews were also considered. More than 4000 articles were identified during the search and 241 were selected to retrieve available evidence on AIT, which was graded according to the Oxford classification. All the group members reviewed the resulting text until the final version reached the consensual agreement. A summary of recommendations on the more relevant topics are proposed. The role of AIT as a valuable therapeutic strategy for prevention of exacerbation and progressive decline in lung function is highlighted. Future research should include specific tools for asthma evaluation when assessing AIT effectiveness in asthmatic patients. ResumenEl asma se asocia frecuentemente con alergia, entendida ésta como la producción de IgE específica frente a alérgenos ambientales. Actualmente, existen dos tipos de inmunoterapia específica con alérgenos (ITE) para la práctica clínica habitual: subcutánea y sublingual, ambas indicadas en el tratamiento de la rinitis y la conjuntivitis alérgicas. Sin embargo, su papel en el asma resulta todavía controvertido. Dominguez-Ortega J, et al.

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Section: Pediatric Populationsmentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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“…[39][40][41] These 3 studies included 135 children, 5 to 14 years of age, with a primary diagnosis of asthma with rhinitis. One study allowed the use of conventional medications, 39 and 2 studies allowed only rescue medications.…”

Section: Study and Populationmentioning

confidence: 99%

“…One study allowed the use of conventional medications, 39 and 2 studies allowed only rescue medications. 40,41 The maintenance dose for SCIT ranged from thrice weekly to monthly; for SLIT, it was thrice weekly in all studies. Treatment duration in each study was 1 year.…”

Section: Study and Populationmentioning

confidence: 99%

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Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Subcutaneous immunotherapy (SCIT) is approved in the United States for the treatment of pediatric asthma and rhinitis; sublingual immunotherapy (SLIT) does not have regulatory approval but is used in clinical practice. The objective of this study was to systematically review the evidence regarding the efficacy and safety of SCIT and SLIT for the treatment of pediatric asthma and allergic rhinoconjunctivitis. METHODS:Two independent reviewers selected articles for inclusion, extracted data, and graded the strength of evidence for each clinical outcome. All studies were randomized controlled trials of children with allergic asthma or rhinoconjunctivitis treated with SCIT or an aqueous formulation of SLIT. Data sources were Medline, Embase, LILACS, CENTRAL, and the Cochrane Central Register of Controlled Trials through May 2012. RESULTS:In 13 trials, 920 children received SCIT or usual care; in 18 studies, 1583 children received SLIT or usual care. Three studies compared SCIT with SLIT head-to-head in 135 children. The strength of evidence is moderate that SCIT improves asthma and rhinitis symptoms and low that SCIT improves conjunctivitis symptoms and asthma medication scores. Strength of evidence is high that SLIT improves asthma symptoms and moderate that SLIT improves rhinitis and conjunctivitis symptoms and decreases medication usage. The evidence is low to support SCIT over SLIT for improving asthma or rhinitis symptoms or medication usage. Local reactions were frequent with SCIT and SLIT. There was 1 report of anaphylaxis with SCIT.CONCLUSIONS: Evidence supports the efficacy of both SCIT and SLIT for the treatment of asthma and rhinitis in children. Pediatrics

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“…Several published prospective studies have compared the efficacy of sublingual to subcutaneous immunotherapy [32][33][34][35][36][37][38][39][40][41], and these are detailed in Table 1: Prospective Studies of SLIT versus SCIT. These studies were published from 1993 to 2011, with dust mite the most common allergen studied (60 %).…”

Section: Efficacy Of Slit Versus Scitmentioning

confidence: 99%

Current Concepts and Update for Sublingual Immunotherapy

Lin

2013

Curr Otorhinolaryngol Rep

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Recent reports of the prevalence of allergic rhinitis in the United States range from 20 to 40 % of the population. Typical symptoms can include nasal obstruction, rhinorrhea, sneezing, and conjunctivitis. Inhalant allergens, such as plant pollens, can cause seasonal symptoms, while perennial symptoms can be induced by dust mites, cockroaches, and certain molds. Allergen specific immunotherapy (SIT) is typically recommended for patients whose allergic rhinoconjunctivitis symptoms cannot be controlled by medications and environmental controls, cannot tolerate their medications, or desire an alternative to pharmacotherapy. While currently the only FDA approved form of SIT in the United States involves subcutaneous injection, sublingual immunotherapy is an alternative ''off-label'' form of allergen desensitization. This review article examines the efficacy and safety of sublingual immunotherapy for the treatment of allergic rhinitis.

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A novel approach in allergen-specific immunotherapy: Combination of sublingual and subcutaneous routes

Cited by 111 publications

References 26 publications

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Current Concepts and Update for Sublingual Immunotherapy

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