Sublingual Immunotherapy (SLIT) for Allergy Treatment: Johns Hopkins | Q&A

By Adem Lewis / in , , , , , , , , , , , , , , , /

[MUSIC] So in my practice, I’ve been
using sublingual immunotherapy for patients with
allergies since 2008. And what I’ve seen is
that patients who have done this therapy and finished
a course are now, many of them, free of taking any
allergy medications and they don’t have
symptoms anymore. They’re able to enjoy
their daily life, while people are sneezing and
having allergic asthma. They are free of those symptoms. So I think that they’ve been
very pleased, as have I, that we’ve been able to
make a difference for them. [MUSIC] Sublingual immunotherapy is
when we take what a person is allergic to and give it to
them in very small amounts. They actually hold it as drops
or a tablet under their tongue and after these controlled
exposures over time, it helps to decrease
the patient’s symptoms. [MUSIC] Sublingual immunotherapy works
after the physician’s done testing to actually confirm
what patients are allergic to. They can get the drops, which
are mixed in the physician’s office, specific to
their allergens, and there are also tablets for
very specific and a limited number of allergens
like ragweed and grass. They can then take either
the tablets or the drops and they hold them under their
tongue for daily dosing. [MUSIC] So sublingual immunotherapy
differs from other allergy medications in the sense that
medications are treating the symptoms. The sublingual immunotherapy’s
actually changing one’s own immune system, so that your immune system is not
as reactive to the allergens. You’re actually treating
the root cause with the immunotherapy, as opposed to just
the symptoms with medicines. [MUSIC] Patients who are a candidate for sublingual immunotherapy
have to meet a few criteria. One is that they have
to have allergies. So your doctor will confirm this
by doing a history and physical. And the other portion is they
have to have their allergies confirmed by some type
of allergy testing, and that can include skin testing or
blood testing. And the final thing I guess is
that the person needs to be able to take the sublingual
immunotherapy. So very young children
can do this, but they need to be able
to follow directions. [MUSIC] So, some of the differences
between the allergy tablets, or the sublingual tablets, and the sublingual drops is that the
tablets have been approved and there are only certain
allergens they can treat. So for example,
if you’re allergic to ragweed, there’s a sublingual tablet for
ragweed. However, some of the advantages
of the drops is that if you’re allergic to multiple things. Say, you’re allergic to 10 or
15 things, we can compound the drops
custom for each patient. [MUSIC] So we know from large scale
studies that sublingual immunotherapy is effective
at reducing the symptoms of allergies such as sneezing,
stuffy nose, runny nose. And it’s also effective in
helping improve symptoms of allergic asthma. [MUSIC] Typically, sublingual
immunotherapy is given daily for a period of several years. The drops are typically given
daily for three to five years. And at this point, the tablets
that are approved for grass and ragweed are given before and
during the season for three consecutive years. [MUSIC] So after a patient stops
the sublingual immunotherapy, there have been studies to show
that their symptoms continue to be diminished and they have
a better quality of life for up to ten years after
stopping the therapy. [MUSIC] Well, one of the benefits of
sublingual immunotherapy is that it’s actually been found
to be safer than injections, and that’s why we can have
a patient doses at home. However, there are still always
the potential for reactions. So the patients who take these
sublingual immunotherapy should be under the care
of a physician and educated on the potential
signs of having a reaction. [MUSIC] Sublingual immunotherapy is in
most patients’ opinions I think, more convenient than shots. The shots require you, for
example, for the first year to go to a doctor’s office and
get the shots. As far as effectiveness, we know
that they’re both effective for allergies and
allergic asthma, but I don’t think there’s been
enough head-to-head steadies to say if one is more
effective than the other. [MUSIC] So some of the advantages
of sublingual immunotherapy compared to traditional allergy
shots is, it’s more convenient, you get to dose it at home. In addition, very young
children a lot of times have trouble tolerating shots. And for the injection or shot
immunotherapy, the first year you have to go in once a week
typically to get a shot. So you can see it’s much more convenient to be able
to do the drops at home. [MUSIC]

12 thoughts on “Sublingual Immunotherapy (SLIT) for Allergy Treatment: Johns Hopkins | Q&A

  1. I had the drops for one and a half years with no result. I recommend injections… wasted thousands of dollars :-/

  2. I'm wondering if this is more helpful for those with severe allergies to those allergens and have severe reactions to injections with immunotherapy…

  3. my doctor did the allergy skin testing (modified prick test method)
    but during the test, i did not feel the prick every time on my back.
    then he told i had dust allergy.
    my question –
    1. did he do the prick test correctly ; i ask because i felt he did not prick my back in all points and i think because of that the fungi, pollens, insect, food – all became not applicable
    2. then he told i have to take sublingual immunotherapy for 2.5 years costing now rs 7000 every 6 months.
    is it necessary. my yoga teacher told with ujjayi pranayam and jal neeti the issue will go away. is it true? so do i so no longer need to take the sublingual immunotherapy
    3. as he told not to lie on bed, i think lying on mat will reduce the issue. is it true. also no need for dust roof zipper cover. and i will wash the sheets every week. but should all sheets be washed together as otherwise dust mites may jump from unwashed sheet to washed sheet making washing less effective?
    4. the issue occurs mostly due to being in house. so i think i should spend more time outdoors
    5. i wet my kerchief and wear when outside. but i think it might be of no use as that is not the allergy i have
    6. in offices, airconditioners are there – do dust mites enter from nose alone or from the office chair/air, if so what to do
    my report says
    positive control -histamine 2hcl 04mm
    negativecontrol gycero saline 01 mm
    mite wheal erythema
    imported dust mite mix ++++ 11
    mite d farinae +++ 8
    mite d pteronyssinus ++ 4
    blomia ++ 4
    rain dust rice ++5
    grain dust wheat ++5
    the rest of the report is no allergy

    i have read SLIT treatment is a bit like homeopathy and i spent 2 year with Byrata Phos with no effect so doctor told to discontinue
    i am sorry for so many questions. right now i am taking airtec fb 400
    if any sources i may read to find answers to these questions, it would help me help myself

  4. Sign me up! I've had dust allergies all my life and have had one sinus surgery. I'm an American living in the UK so where can I find this in the UK?

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