About the La Crosse Method™ Practice Protocol
Providing the broad range of allergy patients with customized treatment options that meet their individual needs is the basis for the La Crosse Method™ Practice Protocol, the most widely-used SLIT protocol in the U.S. The La Crosse Method is intended to offer practitioners a safe, effective option for the full spectrum of allergic patients — from those who are moderately allergic to those whose allergies have become debilitating and ultimately life-threatening.
Why use the La Crosse Method Protocol?
No two patients’ allergic issues are identical — what could be a nuisance for one could be life-threatening for another. Likewise, treatment should reflect individual patient needs. A hallmark of the La Crosse Method Protocol is its ability to meet those individual needs. A combination of one or more La Crosse Method sublingual immunotherapy protocols may be offered to patients based on their history, symptoms, and the number and severity of allergies. Treatment options include:
When considering the appropriate protocol, special consideration should be given to what will ensure the highest level of safety for the patient given his or her history, exam and allergy testing results, i.e. what will offer the maximum benefits with minimal risk. Based on clinical evidence and current scientific research, optimal dosing levels are based on what is therapeutically effective for each individual patient and adjusted accordingly throughout the treatment course.
Because our dose escalation is supported by retesting and monitoring patient response, it minimizes risks of unnecessarily high doses without incremental benefit or adverse events, while simultaneously avoiding a dosing scenario that becomes cost-prohibitive for patients.
Benefits of three times daily dosing
We have observed a combination of clinical symptom improvements, reduced skin test reactivity, and decreases in specific IgE levels at what has been considered “lower” doses of sublingual immunotherapy given three times a day. In 1986, Drs. Scadding and Brostoff published a dust mite study using threshold dosing four times daily. This double-blind, cross-over design study showed improvement in 72% of patients after only two weeks of treatment.
Since then, studies have shown a wide variety of dosing regimen efficacy. In some studies, when higher concentrations of antigen were used, side effects increased without much additional benefit. Frequency of dosing has also ranged from once a week to multiple times per day. Several studies suggest there is more than one mechanism that helps an individual develop tolerance to their allergens.
High-dose intermittent administration of antigen, similar to the La Crosse Method Preseasonal Protocol, produces clonal deletion and/or anergy. The low-dose frequent administration (three times daily dosing) of antigen sublingually leads to active suppression. This approach is used with the La Crosse Method Inhalant and Food Allergen Protocols. Combining multi-antigen threshold dosing with preseasonal “rush” protocols has clinically given providers the ability to take advantage of both mechanisms to develop allergen tolerance in a wide variety of allergic patients.