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Current Evidence on Safety and Practical Considerations for Administration of Sublingual Allergen Immunotherapy (SLIT) in the United States
Univ Cincinnati, Coll Med, Dept Med, Div Rheumatol Allergy & Immunol, Cincinnati, OH USA..
Dilley Allergy & Asthma Specialists, San Antonio, TX USA..
Univ Miami, Miller Sch Med, Holy Cross Hosp, Ft Lauderdale, FL USA..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnallergologi, Pediatric Allergology)ORCID iD: 0000-0002-3544-1557
2017 (English)In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 5, no 1, 34-40 p.Article, review/survey (Refereed) Published
Abstract [en]

Liquid sublingual allergen immunotherapy (SLIT) has been used off-label for decades, and Food and Drug Administration (FDA)-approved grass and ragweed SLIT tablets have been available in the United States since 2014. Potentially life-threatening events from SLIT do occur, although they appear to be very rare, especially for FDA-approved products. Practice guidelines that incorporate safety precautions regarding the use of SLIT in the United States are needed. This clinical commentary attempts to address unresolved issues including controversy regarding the FDA mandate for the prescription of epinephrine autoinjectors for patients on SLIT; how to approach polysensitized patients; optimal timing and duration of SLIT administration; how to address gaps in therapy; whether antihistamines can prevent local reactions, if certain patient populations (such as persistent asthmatics) should not receive SLIT; and when to instruct patients to self-administer epinephrine. Key points are that physicians should focus on educating patients regarding: (1) when not to administer SLIT; (2) how to recognize a potentially serious allergic reaction to SLIT; and (3) when to administer epinephrine and seek emergency care.

Place, publisher, year, edition, pages
2017. Vol. 5, no 1, 34-40 p.
Keyword [en]
Sublingual immunothrapy, adverse drug reaction
National Category
Respiratory Medicine and Allergy
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-320015DOI: 10.1016/j.jaip.2016.09.017ISI: 000396493400004PubMedID: 27815065OAI: oai:DiVA.org:uu-320015DiVA: diva2:1088499
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2017-04-28Bibliographically approved

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