Is Sublingual Immunotherapy Clinically Effective?
Is Sublingual Immunotherapy Clinically Effective?
Purpose of Review: Sublingual immunotherapy has become increasingly popular and in some countries more allergic patients are treated by the sublingual route than the subcutaneous route. Evaluation of the scientific documentation for clinical efficacy is important before a treatment is used unrestrictedly. This review critically analyses every placebo-controlled, double-blind study providing symptom/medication scores for the primary outcome; that is, a significant and clinically relevant reduction in disease severity of actively treated patients.
Recent Findings: In total 23 papers fulfill the evaluation criteria; 26% are categorized as unequivocally effective, 35% are possibly effective (significant improvement in either symptom or medication scores), and 39% have no statistically documented efficacy.
Summary: The majority of papers have used an inadequate study design that may be responsible for the large number of inconclusive and negative studies. Before sublingual immunotherapy can be recommended as a routine treatment, more documentation for beneficial efficacy is needed.
The scope of this review is to evaluate the clinical efficacy of sublingual allergen-specific immunotherapy in allergic disease based on placebo-controlled, double-blind studies published within the last decade. The review intends to give a full overview of published literature presenting clinical efficacy based on symptom/medication scores, and to focus on the characteristics of the scientific outline of studies designed to evaluate clinical efficacy. Furthermore, the relation between the magnitude of clinical efficacy of sublingual allergen-specific immunotherapy and the efficacy obtained by subcutaneous immunotherapy will be discussed in the context of specific treatment of allergies and in the selection of different treatment modalities.
Purpose of Review: Sublingual immunotherapy has become increasingly popular and in some countries more allergic patients are treated by the sublingual route than the subcutaneous route. Evaluation of the scientific documentation for clinical efficacy is important before a treatment is used unrestrictedly. This review critically analyses every placebo-controlled, double-blind study providing symptom/medication scores for the primary outcome; that is, a significant and clinically relevant reduction in disease severity of actively treated patients.
Recent Findings: In total 23 papers fulfill the evaluation criteria; 26% are categorized as unequivocally effective, 35% are possibly effective (significant improvement in either symptom or medication scores), and 39% have no statistically documented efficacy.
Summary: The majority of papers have used an inadequate study design that may be responsible for the large number of inconclusive and negative studies. Before sublingual immunotherapy can be recommended as a routine treatment, more documentation for beneficial efficacy is needed.
The scope of this review is to evaluate the clinical efficacy of sublingual allergen-specific immunotherapy in allergic disease based on placebo-controlled, double-blind studies published within the last decade. The review intends to give a full overview of published literature presenting clinical efficacy based on symptom/medication scores, and to focus on the characteristics of the scientific outline of studies designed to evaluate clinical efficacy. Furthermore, the relation between the magnitude of clinical efficacy of sublingual allergen-specific immunotherapy and the efficacy obtained by subcutaneous immunotherapy will be discussed in the context of specific treatment of allergies and in the selection of different treatment modalities.
