Current Concepts and Update for Sublingual Immunotherapy

Recent reports of the prevalence of allergic rhinitis in the United States range from 20 to 40 % of the population. Typical symptoms can include nasal obstruction, rhinorrhea, sneezing, and conjunctivitis. Inhalant allergens, such as plant pollens, can cause seasonal symptoms, while perennial symptoms can be induced by dust mites, cockroaches, and certain molds. Allergen specific immunotherapy (SIT) is typically recommended for patients whose allergic rhinoconjunctivitis symptoms cannot be controlled by medications and environmental controls, cannot tolerate their medications, or desire an alternative to pharmacotherapy. While currently the only FDA approved form of SIT in the United States involves subcutaneous injection, sublingual immunotherapy is an alternative “off-label” form of allergen desensitization. This review article examines the efficacy and safety of sublingual immunotherapy for the treatment of allergic rhinitis.