Sublingual grass and ragweed immunotherapy: Clinical considerations—a PRACTALL consensus report

Abstract

Sublingual allergen immunotherapy provides a new option for patients with allergic rhinitis in the United States. The efficacy of these sublingual immunotherapy tablets in the treatment of allergic rhinitis has been firmly established in large multicenter clinical trials. In addition, the clinical benefits of sublingual immunotherapy might persist after treatment is discontinued. Local reactions, such as gastrointestinal or oropharyngeal symptoms, are common. However, severe anaphylaxis is rare, and therefore the immunotherapy tablets can be administered at home. Sublingual immunotherapy for allergic rhinitis has been used successfully for years in Europe, and these products might be appropriate for patients who do not do well with standard drug therapy or for those who prefer a disease-modifying approach.

Accurate quantification of 5 German cockroach (GCr) allergens in complex extracts using multiple reaction monitoring mass spectrometry (MRM MS)

“…Standard pharmacotherapy is often partially effective but inadequate to relieve symptoms of allergic rhinitis or impact the clinical course of allergic asthma. By contrast, immunotherapy for environmental allergens such as northern grasses or short ragweed may impact the natural history of allergic diseases . Whether immunotherapy impacts the clinical course of cockroach allergy is unclear, in part because unlike grass and ragweed extracts, there are no established parameters to define biological potency and stability of cockroach allergen extracts.…”

A Comprehensive Review on Kiwifruit Allergy: Pathogenesis, Diagnosis, Management, and Potential Modification of Allergens Through Processing

“…Sublingual immunotherapy is also used for pollen allergies. In Canada there are now four sublingual pollen allergen immunotherapy products: Grastek, Oralair, Acarizax, and Ragwitek which are approved by Health Canada, for patients aged 10 to 65 years with grass or ragweed pollen and dust mite allergy (Li et al., ). Interestingly, although sublingual therapy does reduce the symptoms associated with inhalation of pollens during allergy seasons, there as yet appears to be no significant improvement in OAS in these patients.…”

Allergic conjunctivitis in Asia

“…Clinical trials have shown 2–3 times improvement in visual analog scale and ocular symptom scores; and conjunctival surface challenge required 10–100 times more allergen to provoke a response. Combined symptom and medication score are recommended as the primary outcome measure in all AIT clinical trials [38], with AIT reducing total (nasal plus ocular) symptom/medication score 27%–28% in adults and children [39]. …”