The safety of sublingual immunotherapy, can the rare systemic reactions be prevented?

Autor: Cavaliere C; Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy., Incorvaia C; Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan, Italy., Begvarfaj E; Integrated Activity Head Neck Department, Federico II University, Naples, Italy., Orlando MP; Department of Sense Organs, Sapienza University, Rome, Italy., Turchetta R; Department of Sense Organs, Sapienza University, Rome, Italy., Musacchio A; Department of Sense Organs, Sapienza University, Rome, Italy., Ralli M; Department of Sense Organs, Sapienza University, Rome, Italy., Ciofalo A; Department of Sense Organs, Sapienza University, Rome, Italy., Greco A; Department of Sense Organs, Sapienza University, Rome, Italy., de Vincentiis M; Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy., Masieri S; Department of Sense Organs, Sapienza University, Rome, Italy.
Jazyk: angličtina
Zdroj: Expert opinion on drug safety [Expert Opin Drug Saf] 2021 Mar; Vol. 20 (3), pp. 259-264. Date of Electronic Publication: 2021 Jan 21.
DOI: 10.1080/14740338.2021.1874917
Abstrakt: Introduction : The safety of subcutaneous immunotherapy (SCIT), and particularly the dramatic issue of fatal reactions, has been an obstacle that limited the implementation of a therapy with unique characteristics of action on the causes of allergy. The introduction of sublingual immunotherapy (SLIT) was aimed at solving safety problems while maintaining clinical efficacy. Areas covered : For more than 20 years, SLIT has been based on allergen extracts in drops at low average doses. As evidenced by meta-analyses, the typical adverse events (AE) have consisted of local reactions in the mouth and throat. Unlike the injection route, no correlation was observed between the administered dose and AEs. The development of SLIT products in tablets, based on higher doses than drops, has somewhat changed the concept of SLIT safety. Although large trials, performed to obtain regulatory agency approval, have shown overall high safety, rare anaphylactic reactions have been described. Expert opinion : SLIT is globally safe, and no fatal reactions have ever been reported, but with currently available high biological potency products it is necessary to follow prudential rules, such as the administration of the first dose under medical supervision and the thorough education of patients to avoid taking of higher doses than recommended.
Databáze: MEDLINE