title: Comparison of the long-term efficacy of subcutaneous and sublingual immunotherapies in perennial rhinitis.
abstract: BACKGROUND
  Both sublingual and subcutaneous immunotherapies have a documented clinical efficacy, but only a few comparative studies have been performed.
  
  
  OBJECTIVE
  To evaluate and compare the long-term efficacies of subcutaneous and sublingual immunotherapy.
  
  
  METHODS
  One hundred and ninety-three patients with house dust mite allergies, out of an original total of 230, were treated with subcutaneous and sublingual house dust mite-specific immunotherapies for 3 years and also observed for 3 years after discontinuation of the treatment. The patients were randomized into 2 groups: the sublingual group (97 patients) and the subcutaneous group (96 patients). The therapy's success was evaluated using the symptom score, skin prick test results, and the nasal allergen challenge score. The patients were evaluated at the beginning of the study, at the end of years 1, 2, and 3, and also at the end of the 1st and 3rd years after discontinuation of the specific immunotherapy treatment.
  
  
  RESULTS
  Immunotherapy induced a significant improvement during the treatment and the follow-up period. We found a greater improvement in the subcutaneous group compared to the sublingual group when we looked at the comparative results of the total 6 years.
  
  
  CONCLUSIONS
  We suggest subcutaneous immunotherapy for patients with perennial allergic rhinitis due to the better results that were obtained during our study period. Nevertheless, sublingual immunotherapy is now accepted by WHO as a valid alternative to the subcutaneous route and should be used in all patients who require immunotherapy and do not accept the subcutaneous route of allergen administration.
authors.affiliation: Department of Otolaryngology, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey. tahamiler@gmail.com
authors.forename: Rauf
authors.initials: R
authors.lastname: Tahamiler
authors.forename: Gkioukxel
authors.initials: G
authors.lastname: Saritzali
authors.forename: Salih
authors.initials: S
authors.lastname: Canakcioglu
authors.forename: Engin
authors.initials: E
authors.lastname: Ozcora
authors.forename: Ahmet
authors.initials: A
authors.lastname: Dirican
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D000403:Airway Resistance; D000818:Animals; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000503:physiopathology; D009297:Nasal Mucosa / Q000378:metabolism; D039981:Pyroglyphidae / Q000276:immunology*; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*; D012882:Skin Tests; D012912:Sneezing; D016896:Treatment Outcome