An update on the safety of specific immunotherapy.
OBJECTIVE
As allergen sublingual immunotherapy becomes more widely used in Europe and draws the attention of physicians of the USA, it is important to compare and contrast the safety aspects of this therapy versus allergen subcutaneous immunotherapy.


RESULTS
There are reports of severe systemic reactions associated with sublingual immunotherapy, but no fatalities. There are various studies of systemic reactions, including those that result in death, associated with subcutaneous immunotherapy over its nearly 100-year worldwide experience. Local reactions are common to both forms of the treatment.


CONCLUSIONS
If both forms of therapy are equally effective, a cost (including safety aspects) -benefit analysis of sublingual immunotherapy versus subcutaneous immunotherapy is necessary to determine how best to incorporate both forms of specific immunotherapy into the management of allergic patients. Adherence to published guidelines will reduce the likelihood of adverse reactions.
Windom
Hugh H
HH
Division of Allergy and Immunology, University of South Florida College of Medicine, James A. Haley Veterans' Hospital, Tampa, Florida, USA. hwindom@comcast.net
Lockey
Richard F
RF
D000286:Administration, Sublingual; D000485:Allergens / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D064420:Drug-Related Side Effects and Adverse Reactions; D006287:Health Planning Guidelines; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology / Q000628:therapy*; D007167:Immunotherapy / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D007279:Injections, Subcutaneous / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D006113:United Kingdom
D000485:Allergens