Oral Drops Cut Kids’ Asthma Symptoms
Under-the-Tongue Asthma Therapy Reduces Disease Severity, Research Shows
March 4, 2008 -- An oral alternative to allergy shots shows promise for the
treatment of children with allergic asthma, a review of the
Sublingual immunotherapy (SLIT) involves taking extracts of allergens under
the tongue, which triggers asthma and allergies and increases the
tolerance to these triggers. It works in the same way that allergy shots reduce
allergic sensitivity in many patients over time.
This type of treatment, known as immunotherapy, has been shown effective for
allergic respiratory disease when given in injection form in studies. But the
value of SLIT therapy for the treatment of asthma,
especially in children, has been less clear.
Although a popular treatment for allergies and asthma in many
European countries, sublingual therapy has not been approved for use in the
SLIT Reduces Asthma Symptoms
In the newly published analysis, researchers from Italy's University of
Genoa combined the results of nine studies involving 441 children and teens with allergic asthma
treated with either sublingual immunotherapy or placebo.
They report that treatment with SLIT was associated with a reduction in
symptoms and use of rescue medication for asthma, compared to treatment with
More side effects were seen in the SLIT-treated patients, but none involved
anaphylaxis, which is a rare,
potentially life-threatening complication of injection immunotherapy. The most
common side effects noted in the SLIT-treated patients included oral symptoms,
nose and eye symptoms, and gastrointestinal symptoms.
Researcher Martin Penagos, MD, and colleagues conclude that SLIT appears to
be an effective and safe treatment in children, with the potential to reduce
the severity of asthma symptoms over time.
"Due to the favorable safety profile and its potential in modifying the
evolution of disease, SLIT is of relevant value in the treatment of asthma in
association with standard drug therapy," they write in the March issue of
the journal Chest.
Unanswered Questions About SLIT
Because SLIT does not require weekly or even twice-weekly visits to an
allergist the way allergy shots do, it has the potential to greatly expand the
pool of patients on immunotherapy for allergies and asthma, allergy and asthma specialist Linda S.
Cox, MD, tells WebMD.
"Shots require a big commitment, and right now only about 5% of eligible
patients in this country get them," she says. "Immunotherapy is the
only treatment we have that modifies the course of the disease. Medications
just treat symptoms."
In 2006, a task force made up of members of the nation's leading allergy and
asthma groups weighed in on SLIT, concluding that there is clear evidence that
oral immunotherapy is an effective treatment for allergic disease.
Cox led the task force, which also found that important questions about
sublingual therapy remain unanswered.
Among the most important are the optimal dosage, treatment schedule, and
length of treatment needed.
Dosages and treatment frequency and durations have varied widely in the
studies reported to date, and few have compared different treatment
Though the risk of having a life-threatening allergic reaction to the
treatment appears to be very low with oral immunotherapy, such reactions have
"We have to decide how to deal with that, since this is a treatment that
is given at home," Cox says. "In Europe, it isn't recommended that
patients have injectible epinephrine in the home (to treat anaphylaxis), but we
may choose to be a little more conservative."