Treatment

Sublingual Immunotherapy: Is It Effective for Asthma?

Sublingual immunotherapy (SI) could be beneficial for patients with well-controlled mild-to-moderate asthma and rhinitis, but its effectiveness for individuals with uncontrolled asthma remains unclear, according to the results of a recent review.1

In order to examine the safety and efficacy of SI for adults and children with asthma and to update a 2015 review on the same topic2, the researchers conducted a meta-analysis of 66 parallel randomized controlled trials available through October 29, 2019. Of the 66 studies, 52  had also been included in the original review. Primary outcomes included asthma exacerbations required emergency department visit or hospital admission, validated measures of quality of life, and all-cause serious adverse events.

Overall, despite including 14 additional studies and 2900 additional participants, the results of the review were similar to those of the 2015 review. Few studies reported the effectiveness of SI for asthma exacerbations or quality of life improvement, few reported rates of exacerbation requiring hospital visit, non-validated scales were often used to measure asthma symptoms and medication use, and many of the conclusions were uncertain.

“Despite continued study in the field, the evidence for important outcomes such as exacerbations and quality of life remains too limited to draw clinically useful conclusions about the efficacy of SI for people with asthma. Trials mostly recruited mixed populations with mild and intermittent asthma and/or rhinitis and focused on non-validated symptom and medication scores. The review findings suggest that SI may be a safe option for people with well-controlled mild-to-moderate asthma and rhinitis who are likely to be at low risk of serious harm, but the role of SLIT for people with uncontrolled asthma requires further evaluation,” the researchers concluded.

—Michael Potts

References:

  1. Fortescue R, Kew KM, Leung MST. Sublingual immunotherapy for asthma. Published online September 14, 2020. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD011293.pub3
  2. Normansell R, Kew KM, Bridgman A. Sublingual immunotherapy for asthma. Published online August 28, 2015. Cochrane Database Syst Rev​​​​​​​. https://doi.org/10.1002/14651858.CD011293.pub2