Sublingual allergen immunotherapy (SLIT) is a therapeutic intervention used in the treatment of respiratory allergies, including asthma. Multiple randomized double-blind placebo controlled clinical trials have evaluated the efficacy and safety of SLIT for asthma. These data provide a good platform to critically appraise the evidence to evaluate the effect on SLIT in the management of asthma, for the administration of SLIT by both SLIT-drops and by SLIT-tablets, from a clinical perspective. In this clinical review, presented in a pro and con format, the following domains are examined: i) Evidence from systematic reviews and meta-analyses, ii) Clinical efficacy on asthma symptoms, asthma exacerbations and quality of life, iii) Clinical efficacy on reduction of asthma controller medication, iv) Asthma severity, v) Safety profile, vi) Long-term effect and prevention, vii) International guidelines and viii) Real world evidence. The identified inconsistency in the data is due to wide variations and differences in outcome measures, specific allergens, delivery approaches, schedules, and age group. House Dust Mite (HDM) SLIT-tablet demonstrates efficacy when used in the add-on management of HDM-associated allergic asthma in adults. SLIT for asthma may represent an important advance in the incorporation of a personalized medicine approach in patients with allergic asthma.
Copyright © 2021. Published by Elsevier Inc.