FCAAIA Notes: I have posted many articles on the safety and efficacy of allergy shots. This report confirms that allergy shots are a very safe treatment. However, it also addresses the risk of systemic allergic reactions to sublingual (under the tongue, SLIT) tablets and drops. It is now clear that those treatments also carry risk of severe allergic reactions. There are not large numbers of patients treated and reports yet because of the relative newness of SLIT tablets but by just doing the arithmetic, it is not clear to me that SLIT is all that much safer than subcutaneous immunotherapy (SCIT). Furthermore anyone who has an allergic reaction to SLIT does so at home, not in a medical office, thereby increasing the risk of a bad outcome. All patients on SLIT should have an epinephrine auto-injector at home. Continue reading “SYSTEMIC REACTIONS UNCOMMON WITH SCIT”
FCAAIA Notes: Sublingual immunotherapy (SLIT) tablets are already FDA approved for grass and ragweed. Personally, I have not found that they have a great role in the care of patients here in southwestern Connecticut. There are few patients so allergic to only those allergens that they require immunotherapy. If patients are on injections (subcutaneous allergen immunotherapy, SCIT) for multiple allergens, grass and ragweed are included if indicated. The tablets are very expensive and often not covered by insurance.
However, there are more patients allergic only to dust mites who are bad enough that immunotherapy is indicated. SLIT tablets are an alternative for those patients when they reach the market.
A great weakness in the study and marketing of new products is that they are usually not compared to existing products in head-to-head studies. Continue reading “ODACTRA FIRST SUBLINGUAL THERAPY OK’D FOR HOUSE DUST MITE ALLERGY”
FCAAIA Notes: I have posted many articles about sublingual immunotherapy (SLIT, under-the –tongue) on our web site. Only grass and ragweed tablets are currently licensed in the United States. All other forms of SLIT in the US are not FDA approved and are “off-label”.
In general, allergy shots are at least as or more effective than SLIT. In this study, dust mite SLIT was compared to placebo, but not to dust mite shots. Continue reading “DUST MITE SLIT PROMISING ADD-ON TO ASTHMA MAINTENANCE MEDS”
FCAAIA Notes: We have posted several articles about the safety and efficacy of sublingual immunotherapy (SLIT) for aeroallergen sensitivity. In recent weeks, the FDA has approved sublingual tablets for grass and ragweed immunotherapy, affirming older European data proving that these treatments are better than placebo. The total monthly dose is dramatically higher than that given by injection. In order to achieve these doses, the tablet must be placed under the tongue everyday and be allowed to melt for 10 seconds. There are a few studies comparing SLIT with conventional subcutaneous allergen immunotherapy (allergy shots, SCIT). Those studies show that SCIT is more effective than SLIT.
Of great importance, SLIT tablets are not available in the United States for other allergens. Continue reading “SAFETY AND TOLERABILITY OF SUBLINGUAL IMMUNOTHERAPY IN CLINICAL TRIALS AND REAL LIFE”