August 8, 2018

Does SLIT impact asthma? New review indicates yes.

By Taylor Pasell, Allergychoices

Big news for sublingual immunotherapy came in the form of a comparative effectiveness review recently. A group of allergy researchers compared 31 subcutaneous immunotherapy studies, 18 sublingual immunotherapy studies, and 5 combined studies “to assess the efficacy and safety of immunotherapy for treating allergic asthma.” The results showed that overall, immunotherapy is a valid treatment option for those with allergic asthma.

Mary Morris, MD, ABIM, Allergychoices Medical Advisor

Mary Morris, MD, ABIM

Back in 2012, a group of doctors at Allergy Associates of La Crosse submitted a proposal to the Agency for Healthcare Research and Quality (AHRQ), recommending that they review the quality of sublingual immunotherapy (SLIT) in the treatment of allergic asthma. Dr. Mary Morris, Allergychoices Medical Advisor, and partner and physician at Allergy Associates of La Crosse, was part of this team. She says, “It’s one of those things where we had put in the work of submitting the application for review, and didn’t hear anything for several years. Meanwhile, behind the scenes, lots of people were hard at work doing that research.”

The AHRQ is part of the U.S Department of Health and Human Services, with a mission of producing “evidence to make heath care safer, higher quality, more accessible, equitable and affordable.” Notably, Dr. Morris says, “The AHRQ is what our U.S. government uses to get the most objective opinions about healthcare. What they were looking at is — does immunotherapy, whether it’s sublingual or subcutaneous, have an impact on asthma?”

Nearly six years later, the analysis is in. The review of 54 studies found that both sublingual and subcutaneous immunotherapy have benefits as treatments for allergic asthma. In summary, “sublingual immunotherapy improves asthma symptoms, quality of life and FEV1, and reduces the use of long-term control medications. It may also reduce the use of quick-relief medications.”

Here are the most prominent findings in regard to SLIT:

  • SLIT improves asthma symptoms
  • SLIT improves disease-specific quality of life
  • SLIT decreases the use of long-term control medications
  • SLIT may decrease quick-relief medication use
  • Local reactions are common, but there are few systemic reactions with SLIT

Dr. Morris summarizes the findings. “SLIT reduces the need for medication, definitely reduces the need for oral steroids, and improves objective lung function. It’s getting at the root of the issue rather than just controlling the disease. This article just proves that with big numbers. There have been smaller studies, but this is a compilation of many studies with many people.”

The La Crosse Method™ Protocol for SLIT, in particular, has a high safety profile. There has never been a severe systemic, anaphylactic or near-fatal reaction reported from sublingual immunotherapy treatment following this protocol. “Hives, drop in blood pressure, and throat closing are considered severe systemic reactions. Whereas with sublingual following the La Crosse Method, symptoms are typically mouth itching type of side effects,” Dr. Morris explains.

While this comparison study didn’t have enough data to support the effectiveness of the treatment of allergic asthma in children, the La Crosse Method has had effective results in this population. Through this protocol, treating allergies early on may not only support current asthma symptoms, but can halt the allergic march for many patients.

Dr. Morris is pleased about the release of this comparison study, and explains, “AHRQ reviews are  similar to getting the ‘Good Housekeeping Seal of Approval’ for medical treatment, where they have very strict rules about what studies can and can’t be included.”

Most importantly, Dr. Morris says, “This isn’t just someone’s opinion. The quality of a meta-analysis, when it’s done this way, is very meaningful.” This review is one more step in the right direction toward treating allergies safely, effectively, and affordably.

If you’re interested in treating your asthma and underlying allergies with sublingual immunotherapy, Allergychoices has resources for you.

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