SUBLINGUAL IMMUNOTHERAPY (SLIT)
Emerging Treatment for Allergic Rhinitis - See if SLIT, is the Right Fit, for You!
Allergic rhinitis, sometimes referred to as hay fever, is an allergic inflammatory response producing symptoms including: sneezing, itchy/watery eyes, itchy/runny nose, stuffiness, sinus headaches and more. For many sufferers, medications such as antihistamines, decongestants and prescription nasal spray medications provide only transient or incomplete relief of symptoms. For decades, patients have elected allergy shots (subcutaneous immunotherapy or SCIT) are a long-term treatment alternative.
Allergy shots involve frequent injections of increasing amounts of allergen extract according to a schedule prescribed by your allergist. They can be effective at controlling symptoms of allergic rhinitis, but the injection schedule (at the allergist's medical facility) can be difficult to maintain, local reactions to the injections are common and occasionally intolerable, and severe allergic reactions, very rarely deaths, have been reported.
Another form of immunotherapy has been investigated for use in the United States. Sublingual Immunotherapy (SLIT) involves a dosing schedule with increasing amounts of allergen, much like the shots. However, rather than shots, the allergens are administered as a liquid droplet(s) under the tongue and, are subsequently swallowed after a brief period of waiting.
SLIT is currently commonly used in Europe where roughly 50% of all immunotherapy is given as SLIT. Based on reviews of research projects done both here in the US and overseas, the Cochrane database has conducted an analysis and published findings in December 2010 to conclude that SLIT is a safe and effective treatment for allergic rhinitis in pediatric and adult patients. Side effects have been shown for a minority of patients, but since the risk for serious allergic reactions is remote, SLIT may be selfadministered by the patient outside the allergist's office.
SLIT appears to have a favorable safety profile. In one review of the literature, the authors estimated that in approximately 1.2 million doses administered to 4400 patients, there were no serious, "life-threatening reactions". There are reports of anaphylaxis with SLIT, but the incidence is rare. There have been no fatal reactions reported from SLIT. The primary symptoms reported by subjects attributed to SLIT included mild itching/irritation of the mouth, lips, gums, throat, or ear canals. In addition, worsening nasal allergy symptoms, abdominal pain, nausea / vomiting, and very rarely, an increase in asthma symptoms or anaphylaxis have been reported. Side effects remain rare and the likelihood of treatment-related symptoms is believed to be roughly 20-30%. The side effect reactions reported by subjects receiving SLIT were characteristically mild and less than 5% of subjects believed they were substantial enough to discontinue SLIT.
The effectiveness of SLIT has been studied and confirmed in both adults and children. Dosing appears critical to obtain the maximum benefit from treatment. Some studies have shown that years of therapy are needed before improvement in symptoms is achieved. Many subjects have begun to notice improvement in symptoms during their first upcoming pollen season provided SLIT therapy has been initiated prior to the onset of pollination of these relevant allergens.
The allergists at Frisco Allergy & Asthma Center believe that the evidence indeed supports a benefit for patients receiving SLIT A SLIT protocol available as a treatment option for pediatric and adult patients with seasonal allergic rhinitis. Please review the information provided and discuss with your physician whether SLIT, is the right fit, for YOU!