Sublingunal Immnunotherapy (SLIT) Allergy Drops
Sublingual immunotherapy (SLIT), also known as allergy drops, has been used in the U.S. for more than 35 years, with research dating back 40 years. Its use dates approximately 100 years in some parts of the world. Yet, many allergy sufferers have heard little about this treatment option. Thanks to an increase in European research over the past decade and tremendous growth in the use of allergy drops worldwide, we now have valid scientific evidence that corroborates what many have know for decades---allergy drops are both safe and effective. Sublingual immunotherapy will likely prove to be one of the most important innovations in allergy treatment in the past century.
Until allergy drops are more widely available in the U.S. and more resources are dedicated to educating providers and patients about allergy drops, it’s important to understand the facts about this treatment to help you determine whether it’s the right course of treatment for you.
Frequently Asked Questions
Who should take allergy drops?
Although most allergy sufferers can benefit from allergy drops, they’re especially ideal for people who can’t tolerate or don’t respond to allergy shots, as well as, people who are unable to commit to allergy shot therapy. These people include:
- Infants and Children*
- Highly sensitive people (especially those with a history of anaphylaxis during skin testing or during allergy shots)
- Those on beta-blockers
- Those with chronic conditions including sinusitis
- People with multiple allergies including dust, pollen, mold, animals.
*Allergy drops have proven especially helpful for children with eczema and recurrent ear infection which often have underlying allergic causes. Research shows that many children with untreated eczema and allergies often develop asthma and other chronic conditions later in life, so treating them early can have life-long benefits.
What do they taste like?
Allergy drops have a sweet, minty taste to them and they are tolerated well by children.
What are the advantages of allergy drops?
In addition to being able to treat patients of all ages safely and effectively, there are other advantages to allergy drops:
- Lower cost, fewer clinic visits. Compared to shots, allergy drops cost less and require fewer clinic visits. Most patients receiving allergy drops need only a few clinic visits the first year and once every 6-12 months thereafter until visits are no longer needed.
- More convenient. You can take allergy drops at home, or wherever you need to be, making it much easier to stay with your treatment.
- Less medication. Our patients report, and research confirms, that most patient report needing less medication to control allergy symptoms after beginning allergy drops.
- Enjoy healthier days. The end benefit? Feeling better. Patients typically report fewer clinic visits, hospitalizations and less lost time from work and school after taking drops consistently.
Are allergy drops safe? Is there research validating their effectiveness?
Allergy drops have been used around the world for more than 40 years and numerous studies validate both the safety and effectiveness. Research has confirmed that allergy drops have fewer side-effects than allergy shots. In fact, the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection therapy. The Cochrane Collaboration, the world’s most-trusted international organization dedicated to reviewing healthcare treatments, recently concluded that allergy drop immunotherapy significantly reduced allergy symptoms and the use of allergy medications. This therapy is also endorsed by the American Academy of Otolaryngic Allergy.
How long can I expect the effects of allergy drops to last?
A benefit of immunotherapy-whether its allergy shots or allergy drops-is that it can alter the course of allergic disease by treating the root cause, not just the symptoms. Key studies have already been conducted to explore the long-lasting effect of allergy drops, including a 10-year prospective study on children with asthma that demonstrated drops maintained effectiveness long after treatment stopped.
The key to ensuring that the effects last is patient compliance, which is an additional benefit of allergy drops. Studies show that patients taking allergy drops tend to stay with treatment 90 percent of the time, which is significantly higher than with other routes of treatment. Why is compliance so much higher? Patients appreciate the convenience of being able to take their drops wherever they are, eliminating the need to make frequent clinic visits and the savings in time, and money, that result. They also tend to see improvement around three months, which motivates them to continue a treatment that leaves them continuing to feel better.
But even the best treatments won’t work if you don’t stay with them. Like allergy shot treatment, it’s important to continue with allergy drop treatment until your doctor has determined that treatment can be discontinued. A typical patient will continue treatment for three to four years, depending on the severity of allergic problems.
Continuing with your treatment will help you reap the long-term rewards. A recent study showed that the use of allergy drops with children can significantly lessen the development of asthma later in life---as much as an 80 percent decrease than found in patients who haven’t had immunotherapy. These findings are consistent with the Pediatric Asthma Treatment study done by leading European researchers who found similar results with injection therapy.
I’ve heard that allergy drops are not approved by the FDA. Is that safe?
First, it’s important to understand that the antigens used in allergy drops are the same physician prescribed antigens used in allergy shots. They’re also prepared in the same way as allergy shots. The difference is in the route of administration---a dropper that delivers the antigen under the tongue versus a syringe injecting antigen into tissue.
Currently, antigens are labeled by the FDA for use through injections. Using them for sublingual immunotherapy is an off-label use of an FDA-approved biologic, which is both legal and highly common. Most physicians prescribe “off~label” use of a myriad of drugs today, for example, the use of blood pressures medication for migraines, aspirin for heart conditions, or the use of arthritis drugs for the treatment of shingles.
FDA approval for sublingual immunotherapy is currently pending. Multiple studies are currently being conducted for the purpose of trying to get SLIT approved in the United States, however, it is likely that FDA approval is at least a couple of years away.
If drops are so effective, why don't more patients receive them?
Allergy drops are widely accepted as an effective treatment throughout the world. In fact, 50-75 percent of allergy sufferers in southern Europe are treated with allergy drops. That acceptance is growing throughout the world and is beginning to grow in the United States as the treatment becomes more widely available.