In the future, people may wonder why allergy shots were ever used to treat allergies instead of drops. Allergy drops contain small amounts of an allergen such as ragweed or pollen. They are given under the tongue by a method called sublingual immunotherapy or SLIT.
According to the American College of Allergy, Asthma and Immunology (ACAAI), SLIT is widely used in Europe, South America, Asia and other countries but has not been approved by the Food and Drug Association (FDA) here in the United States.
However, SLIT can and has been used off-label legally in the United States. More and more patients are asking their allergists about it, particularly for use with children.
In order to provide SLIT, an allergist must first do testing to determine what the patient is allergic to. Once this is found, an allergen extract is put into drops or a tablet. The patient holds the extract under their tongue for one to three minutes then swallows.
SLIT may be performed three times a week or as often as daily. Therapy is continued for three to five years to develop and maintain immunity.
Dr. Sandra Lin, an otolaryngologist at Johns Hopkins, is one doctor who has been providing allergy drops for various allergies for her patients to administer to themselves at home.
Dr. Lin and her colleagues recently authored a review published in the Journal of the American Medical Association (JAMA) that reported there was “a moderate grade level of evidence to support the effectiveness of sublingual immunotherapy for the treatment of allergic rhinitis and asthma.”
Participants were 4 to 74 years old. Twenty studies enrolled only children.
No life- threatening adverse reactions were found in the 63 studies they reviewed though local reactions often occurred.
NPR (National Public Radio) stated that the types of local reactions reported in the research review were swelling of the lips and cheeks and “more rarely a systemic reaction like hives.”
The ACAAI added that itching in the mouth or stomach trouble may occur with SLIT but these reactions are usually mild and typically occur in the beginning of therapy.
The idea of giving drops to treat allergies from home is an appealing feature of SLIT. While risks are low, people need to be prepared for them. Allergists should give clear guidance to their patients on how to manage any type of reaction the ACCAI emphasized.
In addition, because SLIT is not an approved therapy at this time, insurance companies will not cover them.
Dr. Lin estimates that it costs $1.50 a day for the first year. Then it reduces to about $1 a day after that.
Allergy drops are in the future of allergy therapy in the United States. But more research will be needed to determine best dosing and how long treatment length should be before being approved by the FDA.
Sources:
Allergy Drops Under The Tongue May Be Fine Alternative To Shots. Health News from National Public Radio. Retrieved April 5, 2013.
http://www.npr.org/blogs/health/2013/03/26/175348886/allergy-drops-under...
Lin, MD Sandra Y et al. Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and Asthma. A Systematic Review. JAMA. 2013;309(12):1278-1288. doi:10.1001/jama.2013.2049.
http://jama.jamanetwork.com/article.aspx?articleid=1672214
Sublingual Immunotherapy (SLIT). Allegist sponsored by the American College of Allergy, Asthma & Immunology. Retrieved April 7, 2013.
http://www.acaai.org/allergist/allergies/Treatment/Pages/sublingual-immu...
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith