Under-the-tongue allergy therapy cost-effective

By Will Boggs, MD

NEW YORK (Reuters Health) - Under-the-tongue or "sublingual" immunotherapy -- what doctors call SLIT -- is cost-effective for treating adults with pollen-induced respiratory allergy, according to a report.

SLIT is not officially in use in the United States, although some allergists use it "with satisfactory results," Dr. Giovanni Passalacqua from University of Genoa, Italy told Reuters Health. "The problem is formal, due to the fact that SLIT has not the approval of the FDA. Clinical studies endorsed by the FDA are currently ongoing to get the approval."

"In Europe the situation is completely different, and SLIT is widely used in many countries (e.g., Italy, Germany, France, Spain, Portugal, Greece, and Hungary)," Passalacqua said.

He and colleagues evaluated the costs and consequences of using SLIT in association with standard allergy treatment compared with standard treatment alone in young adults with pollen-induced allergic rhinitis and asthma.

They found that SLIT leads to a socioeconomic savings by reducing the co-illnesses of rhinitis and drug consumption.

"This fact has been previously envisaged also for injection IT (immunotherapy), but this is the first rigorous assessment made by means of a validated economic model," Passalacqua said.

Specifically, SLIT improved symptoms of 63 percent of patients and prevented asthma in 52 percent of patients, the authors report, compared with 23 percent and 29 percent, respectively, of patients receiving standard treatment.

Compared with standard treatment, SLIT resulted in lower direct and indirect expenses, the researchers note.

SLIT should be regarded as "an additional therapeutic option," Passalacqua said. "Its best advantage is the optimal safety profile and the good acceptance by the patients."

SOURCE: Annals of Allergy, Asthma & Immunology November 2006.