Sublingual Immunothrapy

Allergic rhinitis is one of the most common chronic recurrent diseases in adults and children. Treatment of allergic rhinitis ranges from avoidance of allergens to allergy medications such as anti-histamines and topical nasal steroid sprays to immunotherapy. Immunotherapy is a form of treatment which involves skin testing the patient to determine their specific allergens and then directing treatment accordingly. It is therefore allergen-specific and patient-specific. Its goal is to increase the "immunity" or tolerance to the allergen and therefore reduce allergy symptoms.

Traditional immunotherapy involves giving the patient an "allergy shot" which is generally given weekly over a period of several years to build a lasting response and has been well-proven to be an effective method for treating allergic rhinitis and asthma.

Sublingual immunotherapy is a newer form of immunotherapy in which a custom-mixed vial of drops is prepared for the patient. The patient then takes the drops under the tongue daily for several years. This method of treatment has been used mostly in Europe and has not been approved for use in the United States. Many physician practices in the United States are using sublingual immunotherapy as an "off-label" treatment.

So far, studies of sublingual immunotherapy have primarily focused on grass and dust allergies. There is evidence that sublingual immunotherapy is effective although it may not be as effective as the allergy shot. It does have the disadvantage of having to be dosed on a daily basis and it does require excellent compliance on the part of the patient. It has definitely been shown to be safe and generally well-tolerated. Most insurance plans do not cover sublingual immunotherapy. The drops should be used daily for a minimum of 3-5 years so that the body will build a lasting "immunity".