Evaluations of allergists’ perceptions of, and practice with, sublingual immunotherapy (SLIT) conducted by Mike Tankersley, MD, MBA, and colleagues in 2007 and 2011 occurred prior to the recent approvals of four SLIT options. “Previously, SLIT drops were used that were not FDA-approved nor covered by insurance plans,” he notes. “As therapeutic doses were unknown, many doses were probably no more efficacious than placebo.”

To provide updated information about current allergists’ practice and perception of SLIT in light of these approvals, Dr. Tankersley and colleagues—on behalf of the American College of Allergy, Asthma, and Immunology Immunotherapy (ACAAI) and Diagnostics Committee—sent an electronic survey to all US and international allergists who were members of the. For the study, published in Annals of Allergy, Asthma & Immunology, the researchers compared data with the previous surveys.

“The survey was similar to previous surveys sent to allergists in the previous two studies but with additional survey questions specific to the new FDA-approved products,” explains Dr. Tankersley. “The survey consisted of only eight questions for those who had never used SLIT, 32 questions if the respondent used FDA-approved SLIT tablets, and 41 total questions if SLIT tablets and/or drops had been used.”

Among survey respondents, 73.5% reported experience using SLIT, up significantly from 5.9% of US allergists in 2007 and 11.4% in 2011. Of respondents in the US who used SLIT in their practice, 68.6% used FDA-approved SLIT tablets only, 23.4% used both FDA-approved SLIT tablets and SLIT drops using an extract that is FDA approved for subcutaneous immunotherapy (SCIT), and 8.0% reported using only SLIT drops. Among 73.5% of respondents, the limitation of only treating one allergen was the primary barrier to using SLIT. Dr. Tankersley notes that only three allergens are currently available with SLIT (house dust mite, ragweed and two northern grass products) and that SLIT tablets must be taken daily for 3-5 years, whereas SCIT can cover all allergens and be given once monthly for 3-5 years upon achieving a maintenance dose. “But patients unable or unwilling to do SCIT now have an FDA-approved alternative in SLIT,” he adds. “the findings of this study show that US allergists have embraced SLIT tablets and are offering them as a treatment option for their patients. There’s no reason 100% of US allergists shouldn’t be offering SLIT tablets for their allergic patients.”


Perception and practice of sublingual immunotherapy among practicing allergists in the United States