Sublingual Immunotherapy/Allergy Drops

Treating an allergy’s underlying cause is the focus of all immunotherapy as compared to over-the-counter and prescription drugs, which only provide relief from symptoms.

How successful is Immunotherapy?

One out of five Americans suffer from allergies. For some, allergies are simply a short lived nuisance; however for millions it’s a life altering disease. The only treatment that reprograms the overreacting immune system is immunotherapy, which involves gradual delivery of the substances that trigger allergies to acclimate the body to the world around it.

Over 85% of patients who receive immunotherapy over the recommended period of time experience significant improvement or complete relief from their symptoms. With these ongoing treatments, both seasonal and perennial allergies will improve and your use of allergy medications will decrease.

Currently, in the U.S. an estimated three million people are in immunotherapy treatment. Almost all of these patients are seen by allergists and are treated with injection immunotherapy.

In other parts of the world physicians are expanding the use of immunotherapy by introducing the allergens to the body through sublingual immunotherapy (SLIT). Up to 75% of allergy sufferers in Europe use antigen drops under the tongue for their allergy treatment.


Allergy sublingual drop immunotherapy (SLIT)

Allergy drops work much like shots, slowly desensitizing you to your allergies. They’re delivered under the tongue in a drop form that patients can take at home. With today’s busy lifestyles, drops are an ideal solution for many of our allergy patients who can’t find the time to come in for a weekly shot. Because of their safety profile they are also the ideal way to administer immunotherapy to children, those patients highly reactive to shots, asthmatics and those with “needle phobia. Like shots, most patients find their treatment takes three to five years to complete.

Allergy drops works by delivering a slowly increasing dose of the allergic causing substance called an antigen ** by building up the body’s tolerance to that antigen

(**An antigen is an allergy-causing substance, examples include dust, pollen, mold, insect venom and specific foods such as fish, wheat, nuts and eggs)

Like allergy shots, the drops are a specifically tailored treatment for each patient’s specific cause of their allergy.

Allergy drops are placed under the tongue and affect the immune system through very specialized cells found under the tongue. Research shows these cells are an effective route for long-term desensitization, making it an ideal option for patients who don’t want or aren’t candidates for allergy shots Allergy drops are taken daily for an average of two to three years.

Another major difference with allergy drops as compared to allergy shots is that they can be taken safely at home and don’t need to be given in a doctor’s office. With today’s busy lifestyles, allergy drops are an ideal solution for many of our allergy patients who can’t find the time to come in for a weekly shot.

Broader application, increased safety, ease of use, higher compliance and lower costs are all advantages of sublingual immunotherapy.


Who benefits from allergy drops?

Although most people who suffer from allergies and related illnesses can benefit from allergy drops, many people aren’t aware it’s an option. For those whose allergies prevent them from living a full, productive life, allergy drops provide an effective, safe and cost-effective option.

Through its safety profile, SLIT allows patients who are not candidates for injection immunotherapy to receive the benefits of immunotherapy. These include children, highly reactive patients who can’t tolerate shots or don’t respond to shots, asthmatics, and those with food allergies.


Who are the best candidates for sublingual immunotherapy?

Although most people who suffer from allergies and related illnesses can benefit from allergy drops, many people are not aware that drops are a viable option. Allergy drops are especially helpful for people who can’t tolerate or don’t respond to allergy shots, including:

  • Infants and children. Allergy drops have proven especially helpful for children with eczema and recurrent ear infections, which often have underlying allergic causes. Research shows that many children with untreated eczema and allergies often develop asthma and other chronic conditions later in life, so treating them early can have lifelong benefits.
  • Severe asthmatics. Research studies show positive outcomes when sublingual was used to treat asthma, and a number of additional studies are currently underway. SLIT can provide desensitization for triggers and thus moderate the need for medication for our asthma patients. And because of its safety profile, even severe asthmatics can be given a chance to reduce their symptoms.
  • Patients with chronic conditions including sinusitis. Recent research has validated the longstanding view that chronic sinus conditions and allergies are connected. Treating the underlying allergic disease with SLIT has shown favorable results in patients with chronic sinus conditions.
  • Patients with food and mold allergies. Other than avoidance and symptom relief, there has been little to offer patients suffering from these allergies. Clinical evidence shows a great deal of promise in treating food and mold allergies through sublingual immunotherapy, which even the most sensitive patients can tolerate. Additional research is currently underway to corroborate clinical findings in the U.S., and a number of European studies indicate its effectiveness.
  • Highly sensitive patients. SLIT may be the ideal solution for patients who are “needle averse,” unwilling or unable to undergo injection therapy. This includes patients who have experienced systemic reactions to injection therapy, who dread shots, who cannot travel and especially those who are young.
  • Patients with multiple allergies including dust, pollens, animals and chemicals have shown marked improvements after following a regular SLIT treatment regimen.


What are the advantages of allergy drops?

Easy to use. Allergy drops are simply placed under the tongue, and are used on a daily basis.
More patients can be treated – Highly sensitive patients. Many patients especially those with asthma, young children, and those who aren’t able to tolerate shots, can now be treated with immunotherapy.Drops can now provide desensitization to even severe asthmatics who for mostly safety reasons, were unable to tolerate injections

Lower cost, fewer clinic visits
Compared to shots, allergy drops cost less and require fewer clinic visits. Most patients receiving allergy drops need only a few clinic visits a year.

More convenient
You can take allergy drops at home or wherever you are – even while traveling as they need no special storage, thus making it much easier to stick with treatment.

Infants and children
Allergy drops have proven especially helpful for children with eczema and recurrent ear infections, which often have underlying allergic causes. Research shows that many children with untreated allergies develop asthma and other chronic conditions later in life, so treating them early can have lifelong benefits.

More allergy-free days
Many patients find they need less medication to control symptoms after being on allergy drops. Our patients typically report fewer clinic visits, less time lost from work and school, after taking their allergy drops consistently

Chronic sinusitis patients
In many patients, chronic sinus and allergies are related. Treating the underlying allergic disease with drops has shown favorable results in reducing the frequency of their sinus infections.


Are Allergy Drops Safe and Effective?

Allergy drops have been used for more than 50 years, and most studies show that they are safe and effective. Dosing levels and the route of administration are safe enough to effectively treat infants, children, and people suffering from chronic conditions that previously made them unable to receive immunotherapy via shots. We at San Francisco ENT and Allergy have a strong track record of safety and success with this form of treatment.

In fact, the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection therapy.

The well-respected Cochrane Collaboration, the world’s most-trusted international organization dedicated to reviewing healthcare treatments, recently concluded allergy drop immunotherapy significantly reduced allergy symptoms and use of allergy medications.

The safety profile for sublingual immunotherapy is superior to injection based on research studies and patient treatment experience. Systemic reactions occur 3x less with sublingual, and there has never been and anaphylactic reaction (life threatening) recorded over the 30+ years of sublingual treatment.
Compliance has not been studied extensively. However, one large managed-care organization did find 50% of patients receiving allergy shots dropped out of therapy during the first year. In looking at sublingual compliance among patients in many of the studies identified previously, approximately 90% of patients complete their treatment.


Treatment Steps

Sublingual immunotherapy treatment is similar to injection therapy, with a few unique additions.

Testing & Evaluation
The first step is to confirm which allergies are present and how severe they are. The medical history plays a large role here. Skin or blood testing is used to confirm suspected allergies.

Environmental Control
Once allergies are confirmed, we help patients find ways to avoid allergens by suggesting changes in diet and lifestyle when possible.

Pharmacology
To help reduce symptoms, you might be prescribed medications, such as non-sedating antihistamines and nose sprays. As treatment continues, most patients find their need for medication decreases.