Abstract
Although sublingual immunotherapy (SLIT) is a common adjuvant treatment for allergic rhinitis and allergic asthma in Europe, it is used minimally in the United States because of lack of approval by the US Food and Drug Administration (FDA) of allergen extracts for sublingual treatment and inconsistent study findings on extract potency, dosing levels, and dosing schedules. Data are particularly lacking on use of SLIT in pediatric patients, who may represent a potential patient population for this type of immunotherapy delivery because of its favorable safety and acceptability to children compared to subcutaneous immunotherapy (SCIT). Differences in the mechanism of action of SLIT compared to SCIT may also confer some treatment and safety advantages. Clinical trials on SLIT in pediatric patients have provided inconsistent results, but this inconsistency may be due in part to less than optimum dosing and durations of treatment. The appeal of SLIT as a treatment in children is further enhanced by its potential for possibly preventing progression to asthma if initiated at a young age. This article reviews the clinical evidence on studies in pediatric populations regarding efficacy and safety, and its implications in the treatment of allergic rhinitis and allergic asthma in children.
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