Keisuke Masuyama1, Minoru Goto2, Sachio Takeno3, Nobuo Ohta4, Mitsuhiro Okano5, Atsushi Kamijo6, Motohiko Suzuki7, Tetsuya Terada8, Daiju Sakurai9, Shigetoshi Horiguchi10, Kohei Honda11, Shoji Matsune12, Takechiyo Yamada13, Masafumi Sakashita13, Atsushi Yuta14, Takashi Fuchiwaki15, Ikuyo Miyanohara16, Takeo Nakayama17, Yoshitaka Okamoto9, Shigeharu Fujieda18. 1. Department of Otorhinolaryngology, University of Yamanashi, Japan. 2. Department of Otorhinolaryngology - Head and Neck Surgery, Nippon Medical School, Japan. 3. Department of Otolaryngology - Head and Neck Surgery, Hiroshima University, Japan. 4. Department of Otolaryngology - Head and Neck Surgery, Yamagata University, Japan. 5. Department of Otolaryngology - Head and Neck Surgery, Okayama University, Okayama, Japan. 6. Otorhinolaryngology/Allergy Center, Saitama Medical University, Japan. 7. Department of Otolaryngology - Head and Neck Surgery, Nagoya City University, Japan. 8. Department of Otorhinolaryngology, Osaka Medical University, Japan. 9. Department of Otolaryngology - Head and Neck Surgery, Chiba University, Japan. 10. Departments of Otorhinolaryngology and Allergology, Iida Hospital, Japan. 11. Department of Otorhinolaryngology - Head and Neck Surgery, Akita University, Japan. 12. Department of Otolaryngology Nippon Medical School, Musashikosugi Hospital, Japan. 13. Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan. 14. Yuta Clinic, Japan. 15. Department of Otorhinolaryngology, Shimane University, Japan. 16. Department of Otolaryngology - Head and Neck Surgery, Kagoshima University, Japan. 17. Department of Health Informatics, Kyoto University School of Public Health, Japan. 18. Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan. Electronic address: sfujieda@u-fukui.ac.jp.
Abstract
OBJECTIVE: Sublingual immunotherapy (SLIT) appears to offer practical advantages for the treatment of allergic rhinitis (AR). Based on a review of the scientific literature, we present recommendations as guiding principles to administer SLIT safely. METHODS: Clinical questions concerning SLIT were prepared. Literature published between January 2003 and December 2012 was searched from PubMed, the Cochrane Library, and Japana Centra Revuo Medicina. Qualified studies were analyzed and the results were evaluated, consolidated, and codified. We answered 17 clinical questions and, based on this, presented evidence-based recommendations. RESULTS: Sublingual immunotherapy improved symptoms (e.g., quality of life [QOL]) and reduced medication scores in seasonal AR and perennial AR. Most SLIT-induced adverse effects were local oral reactions, although systemic adverse effects such as gastrointestinal symptoms, urticaria, and asthma are occasionally reported. There have been no reports of lethal anaphylactic reactions by SLIT. When SLIT is continued for 3-4 years, its effect persists long after discontinuation. CONCLUSION: A correct diagnosis of AR and sufficient informed consent from patients are required before initiating SLIT. Sublingual immunotherapy should be continued for 3 years or longer. The initial administration of SLIT during the uptitration of an allergen vaccine and the general condition of patients are critical for the safe performance of SLIT.
OBJECTIVE: Sublingual immunotherapy (SLIT) appears to offer practical advantages for the treatment of allergic rhinitis (AR). Based on a review of the scientific literature, we present recommendations as guiding principles to administer SLIT safely. METHODS: Clinical questions concerning SLIT were prepared. Literature published between January 2003 and December 2012 was searched from PubMed, the Cochrane Library, and Japana Centra Revuo Medicina. Qualified studies were analyzed and the results were evaluated, consolidated, and codified. We answered 17 clinical questions and, based on this, presented evidence-based recommendations. RESULTS: Sublingual immunotherapy improved symptoms (e.g., quality of life [QOL]) and reduced medication scores in seasonal AR and perennial AR. Most SLIT-induced adverse effects were local oral reactions, although systemic adverse effects such as gastrointestinal symptoms, urticaria, and asthma are occasionally reported. There have been no reports of lethal anaphylactic reactions by SLIT. When SLIT is continued for 3-4 years, its effect persists long after discontinuation. CONCLUSION: A correct diagnosis of AR and sufficient informed consent from patients are required before initiating SLIT. Sublingual immunotherapy should be continued for 3 years or longer. The initial administration of SLIT during the uptitration of an allergen vaccine and the general condition of patients are critical for the safe performance of SLIT.
Authors: Désirée Larenas-Linnemann; Noel Rodríguez-Pérez; Jorge A Luna-Pech; Mónica Rodríguez-González; María Virginia Blandón-Vijil; Blanca E Del-Río-Navarro; María Del Carmen Costa-Domínguez; Elsy Maureen Navarrete-Rodríguez; Carlos Macouzet-Sánchez; José Antonio Ortega-Martell; César Fireth Pozo-Beltrán; Alan Estrada-Cardona; Alfredo Arias-Cruz; Karen Guadalupe Rodríguez Galván; Herson Brito-Díaz; María Del Rosario Canseco-Raymundo; Enrique Emanuel Castelán-Chávez; Alberto José Escalante-Domínguez; José Luis Gálvez-Romero; Javier Gómez-Vera; Sandra Nora González-Díaz; María Gracia Belinda Guerrero-Núñez; Dante Daniel Hernández-Colín; Alejandra Macías-Weinmann; David Alejandro Mendoza-Hernández; Néstor Alejandro Meneses-Sánchez; María Dolores Mogica-Martínez; Carol Vivian Moncayo-Coello; Juan Manuel Montiel-Herrera; Patricia María O'Farril-Romanillos; Ernesto Onuma-Takane; Margarita Ortega-Cisneros; Lorena Rangel-Garza; Héctor Stone-Aguilar; Carlos Torres-Lozano; Edna Venegas-Montoya; Guillermo Wakida-Kusunoki; Armando Partida-Gaytán; Aída Inés López-García; Ana Paola Macías-Robles; María de Jesús Ambriz-Moreno; Amyra Ali Azamar-Jácome; Claudia Yusdivia Beltrán-De Paz; Chrystopherson Caballero-López; Juan Carlos Fernández de Córdova-Aguirre; José Roberto Fernández-Soto; José Santos Lozano-Sáenz; José Joel Oyoqui-Flores; Roberto Efrain Osorio-Escamilla; Fernando Ramírez-Jiménez; Daniela Rivero-Yeverino; Eric Martínez Infante; Miguel Alejandro Medina-Ávalos Journal: World Allergy Organ J Date: 2020-08-21 Impact factor: 4.084