Sublingual Specific Immunotherapy: State of the Art

Abstract

Sublingual immunotherapy (SLIT) was first attempted more than a century ago. After a long parenthesis probably related to the lack of impressive clinical results, the advances on allergen quantification and characterization, together with the improvements in the recombination techniques have renewed the interest in this therapy during the past decade. There are currently enough high quality clinical trials on its efficacy in the management of respiratory allergies (asthma and rhinoconjunctivitis) to conclude that SLIT could be an effective tool for the management of those diseases. This effectiveness has been shown both in children and in adults. However, while there are some clues related to the mechanism of action of SLIT, there is still much to know about it. In addition, more studies comparing the effectiveness of SLIT vs the standard subcutaneous immunotherapy (SCIT) are needed to definitely establish the role of SLIT in the treatment of allergic diseases. SLIT has proven a very safe therapy as compared to SCIT, a fact which adds a very important advantage to the sublingual route.

Sublingual ketorolac versus sublingual tramadol for moderate to severe post-traumatic bone pain in children: a double-blind, randomised, controlled trial

“…It has previously been used and shown to be effective in adults 24 25. Children from the age of 6 years onwards have been shown to be able to take sublingual drugs with adequate interactions and support by nurses 26 27…”

Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen

“…3 In the past 15 years, sublingual immunotherapy (SLIT) has become a widely accepted alternative in European countries, 2,4 but not in the United States. 5 SLIT has been shown to be effective in the management of rhinoconjunctivitis and asthma in both adults and children, 3,4,[6][7][8][9][10][11][12] with the potential to confer greater benefit than SCIT in terms of tolerability and safety, accessibility, and improved antigen delivery. 2,13 Previous SLIT studies had major shortcomings, including small patient populations, high withdrawals, short treatment duration, and inadequate randomization data.…”

Narrative review shows that the short‐term use of ketorolac is safe and effective in the management of moderate‐to‐severe pain in children

“…Sublingual administration may have several advantages, such as improved bioavailability and more comfortable administration, compared to the intravenous route. Children from the age of six and above have been shown to be able to take sublingual drugs with adequate support from nurses . Ketorolac is absorbed more rapidly after sublingual than intramuscular administration: the sublingual route takes about half an hour to achieve an increase in peak concentration, and a reduction in the time to attain this, compared to one hour for the intramuscular route (Fig.…”