Allergy season started early and is predicted to be intense in 2017, raising the specter for certain patients to develop asthma.
For DOs in primary care, sublingual immunotherapy (SLIT) products offer a convenient treatment option for pediatric and adult patients with allergic rhinitis, according to Massoud Mahmoudi, DO, PhD, the president of the American Osteopathic College of Allergy and Immunology. While subcutaneous immunotherapies (SCIT) are an obvious option, many patients forego treatment because it requires frequent appointments for medically supervised administration.
SLIT eliminates the time and travel barrier because it is administered at home. Research shows SLIT adherence is equally as poor as SCIT, although patient compliance improves when three-month follow ups are required to update prescriptions. SLIT also seems to work best if used with one or two allergens, while SCIT is shown effective for multiple-allergen extracts.
“As DOs we believe in the body’s self-healing ability. Allergy immunotherapy consists of exposing the same allergens to the allergic patient, which means no medication is added to the regimen. The body will do the rest, by making antibodies to the exposed allergens,” Dr. Mahmoudi explained.
Both SCIT and SLIT can modify the immune system in the treatment of allergic rhinitis, reducing allergen sensitization and decreasing the patient’s likelihood of developing asthma. The current evidence suggests that SCIT is more effective than SLIT in reducing symptoms and medication need, although head-to-head trials with the three currently approved tablets and conventional SCIT have not been performed.
AOA HealthWatch offers a 1-B credit-eligible update on the treatment of allergic rhinitis, recommended for primary care physicians. The CME offering is supported by an independent educational grant from Merck.