Caveat Emptor on Sublingual Immunotherapy
Editor's Note
Editor's Note
Caveat Emptor on Sublingual Immunotherapy Patrick G. O’Malley, MD, MPH
The synthesis of clinical trials of sublingual immunotherapy for grass pollen allergy by Di Bona et al1 in this issue indicates an unimpressive small effect, and the efficacy is even smaller in the United States compared with European popuRelated article lations. However, what was impressive is the 70.0% (1817 of 2597 patients) proportion experiencing adverse effects (mostly mouth itching or burning and gastrointestinal tract symptoms). As these sublingual Conflict of Interest Disclosures: None reported. 1. Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Di Lorenzo G. Efficacy of grass pollen allergen sublingual immunotherapy tablets for seasonal
jamainternalmedicine.com
agents become increasingly available and heavily advertised, it will be prudent for physicians to be aware of these data, in addition to their cost (approximately $90 for a 3-month supply, plus the requirement to coprescribe an epinephrine autoinjector). Sublingual immunotherapy may seem more convenient than nasal corticosteroids or subcutaneous immunotherapy and therefore tempting to prescribe, but the evidence shows minimal benefit and moderate adverse effects for patients with seasonal grass pollen allergies.
allergic rhinoconjunctivitis: a systematic review and meta-analysis [published online June 29, 2015]. JAMA Intern Med. doi:10.1001/jamainternmed.2015 .2840.
(Reprinted) JAMA Internal Medicine Published online June 29, 2015
Copyright 2015 American Medical Association. All rights reserved.
Downloaded From: http://archinte.jamanetwork.com/ by a Universite Laval User on 07/10/2015
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Editor's Note
Editor's Note
Caveat Emptor on Sublingual Immunotherapy Patrick G. O’Malley, MD, MPH
The synthesis of clinical trials of sublingual immunotherapy for grass pollen allergy by Di Bona et al1 in this issue indicates an unimpressive small effect, and the efficacy is even smaller in the United States compared with European popuRelated article lations. However, what was impressive is the 70.0% (1817 of 2597 patients) proportion experiencing adverse effects (mostly mouth itching or burning and gastrointestinal tract symptoms). As these sublingual Conflict of Interest Disclosures: None reported. 1. Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Di Lorenzo G. Efficacy of grass pollen allergen sublingual immunotherapy tablets for seasonal
jamainternalmedicine.com
agents become increasingly available and heavily advertised, it will be prudent for physicians to be aware of these data, in addition to their cost (approximately $90 for a 3-month supply, plus the requirement to coprescribe an epinephrine autoinjector). Sublingual immunotherapy may seem more convenient than nasal corticosteroids or subcutaneous immunotherapy and therefore tempting to prescribe, but the evidence shows minimal benefit and moderate adverse effects for patients with seasonal grass pollen allergies.
allergic rhinoconjunctivitis: a systematic review and meta-analysis [published online June 29, 2015]. JAMA Intern Med. doi:10.1001/jamainternmed.2015 .2840.
(Reprinted) JAMA Internal Medicine Published online June 29, 2015
Copyright 2015 American Medical Association. All rights reserved.
Downloaded From: http://archinte.jamanetwork.com/ by a Universite Laval User on 07/10/2015
E1
