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I Dávila1, A Navarro2,
J Domínguez-Ortega3, A Alonso4, D
Antolín-Amérigo5, MC Diéguez6, E
González-Mancebo7, C Martín8, C
Martínez9, B Núñez10, N Prior11,
M Reche12, A Rosado13, J
Ruiz-Hornillos14, A Sansosti15, M
Torrecillas16, MJ Jerez17; QUASAR
Group (QUality in the Administration of SLIT in Allergic
Rhinitis) |
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1Servicio de Alergia,
Hospital Universitario de Salamanca, IBSAL, Salamanca
2UGC Intercentros Alergología Sevilla,
Hospital El Tomillar, Sevilla
3Servicio de Alergia, IDIPAZ, Hospital
Universitario La Paz, Madrid
4Alianza Médica, Valladolid
5Servicio de Enfermedades del Sistema
Inmune-Alergia, Hospital Universitario Príncipe de
Asturias, Alcalá de Henares, Madrid
6Servicio de Alergia, Hospital Universitario
Doce de Octubre, Madrid
7Unidad de Alergia, Hospital Universitario de
Fuenlabrada, Madrid
8Servicio de Alergia, Complejo Hospitalario
de Zamora
9Servicio de Alergia, Complejo Hospitalario
de Zamora
10Unidad de Alergia, Hospital Universitario
de Getafe, Madrid
11Unidad de Alergia, Hospital Universitario
Severo Ochoa, Leganés, Madrid
12Servicio de Alergia, Hospital Universitario
Infanta Sofía, San Sebastián de los Reyes, Madrid
13Unidad de Alergia, Hospital Universitario
Fundación Alcorcón, Madrid
14Unidad de Alergia, Hospital Universitario
Infanta Elena ISS-FJD, Valdemoro, Madrid
15Servicio de Alergología, Althaia, Xarxa
Assitencial Universitaria de Manresa, Barcelona
16Servicio de Alergia, Complejo Hospitalario
Universitario de Albacete
17Nature Publishing Group Iberoamérica,
Madrid |
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Abstract |
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Specific sublingual
immunotherapy (SLIT)
has been proved to
be a safe and
effective approach
in respiratory
allergy. However,
further research is
required on aspects
such as patient
selection, use of
optimal dosing,
effects on asthma,
long-term effects,
and management of
adverse reactions.
In addition, the
widely heterogeneous
nature of studies on
SLIT performed to
date and the
application of the
criteria for
subcutaneous
immunotherapy make
it difficult for the
prescribing
clinician to draw
accurate and useful
conclusions.
Therefore, the
QUASAR Group (QUality
in the
Administration of
SLIT in Allergic
Rhinitis), which
comprises
allergologists with
broad clinical
experience in SLIT,
investigated the
latest research
findings and
available data on
this approach.
Working parties were
formed in 3
different
categories:
selection of
candidates for SLIT,
treatment efficacy,
and adverse
reactions. We
performed a PubMed
search for articles
that were
representative of
each category and
found 850. From
these, we finally
selected 266
articles, which were
reviewed to retrieve
data on SLIT.
Evidence for each
clinical question
was graded according
to the Oxford
classification. The
resulting text was
evaluated on 3
occasions by all the
members of the group
until the final
version was agreed
upon. In this
version, we review
available evidence
on SLIT,
particularly with
pollens, which is
the subject of most
articles. In areas
where evidence is
insufficient, an
alternative agreed
upon by the members
of the QUASAR group
is presented.
Finally, we propose
algorithms for
selecting candidates
for SLIT and for
management of
adverse events.
Key words:
SLIT. Adverse
reactions. Evidence.
Adherence. Efficacy
of SLIT. Patient
selection. Allergic
rhinitis. |
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