Are there non-injectable desensitization methods for allergic rhinitis due to pollen allergy?

From the Guidelines

Non-injectable desensitization methods, specifically sublingual immunotherapy, are a viable alternative to parenteral injection therapy for allergic rhinitis due to pollen allergy. The most recent and highest quality study 1 suggests that sublingual immunotherapy is effective in adults and children, with a significant reduction in symptom and medication scores. Some key points about sublingual immunotherapy include:

• It is effective in patients sensitized to 2 non–cross-reacting allergens, such as grass and birch
• The allergen is not degraded by saliva and there is no direct sublingual absorption of allergen
• Radiolabeled allergen has been detected after 48 hours in the sublingual region
• Alternative protocols, such as rush and ultra-rush sublingual swallow induction, have been studied
• Sublingual immunotherapy appears to be safe, even at very high doses, and is associated with a lower incidence of serious side effects. However, it is essential to note that a consistent relationship among allergen dose, treatment duration, and clinical efficacy has not been established, and further studies are needed to confirm the optimal dose for sublingual immunotherapy 1. Some of the benefits of sublingual immunotherapy include:
• It can be taken at home
• It has a lower incidence of serious side effects compared to injectable immunotherapy
• It can be effective in young children (<5 years), for whom there are prospective safety data and a postmarketing survey 1. Overall, sublingual immunotherapy is a promising non-injectable desensitization method for allergic rhinitis due to pollen allergy, and it should be considered as a viable alternative to parenteral injection therapy.

From the Research

Non-Injectable Desensitization Methods for Allergic Rhinitis

There are non-injectable desensitization methods for allergic rhinitis due to pollen allergy, including:

• Sublingual immunotherapy (SLIT) 2, 3, 4, 5, 6
• Sublingual tablets or drops 2, 3, 4, 5, 6

Efficacy of Non-Injectable Desensitization Methods

The efficacy of these methods has been demonstrated in various studies, including:

• A systematic review and meta-analysis of SLIT for allergic rhinitis, which found a significant reduction in symptoms and medication requirements 2
• A meta-analysis-based comparison of subcutaneous and sublingual immunotherapy for seasonal allergic rhinitis, which found that subcutaneous immunotherapy was more effective than sublingual immunotherapy 3
• A randomized, double-blind, placebo-controlled trial of sublingual immunotherapy with standardized quality grass allergen tablets, which found that the treatment was well tolerated and displayed systemic immunogenicity 4
• A review of the evidence supporting the efficacy and safety of subcutaneous immunotherapy and sublingual forms of immunotherapy for allergic rhinitis/conjunctivitis and asthma, which found that these treatments are effective and safe 5
• An observational study of patient needs and benefits of sublingual immunotherapy for grass pollen-induced allergic rhinitis, which found that treatment with sublingual immunotherapy was associated with considerable patient-relevant benefit in all age groups 6

Characteristics of Non-Injectable Desensitization Methods

The characteristics of these methods include:

• Sublingual immunotherapy can be administered via drops or tablets 2, 3, 4, 5, 6
• Treatment can be given for a variety of allergens, including grass pollen, house dust mites, and tree pollen 2, 3, 4, 5, 6
• Treatment can be given to patients of all ages, including children and adults 2, 3, 4, 5, 6