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Review
. 2023 Oct 4:11:1244146.
doi: 10.3389/fped.2023.1244146. eCollection 2023.

A practical guide to prescribing sublingual immunotherapy tablets in North America for pediatric allergic rhinoconjunctivitis: an injection-free allergy immunotherapy option

Michael Blaiss  1 , Lawrence DuBuske  2 , Hendrik Nolte  3 , Morten Opstrup  4 , Karen Rance  3
Affiliations
Review

A practical guide to prescribing sublingual immunotherapy tablets in North America for pediatric allergic rhinoconjunctivitis: an injection-free allergy immunotherapy option

Michael Blaiss et al. Front Pediatr. .

Abstract

Allergic rhinoconjunctivitis (ARC) is a common disease that affects individuals of all ages. Pediatricians may be the first (and only) point of care for children with ARC. Sublingual immunotherapy (SLIT)-tablets are a convenient at-home, injection-free allergy immunotherapy option that can be used for the treatment of ARC. This paper provides a practical guide for pediatricians to aid in prescribing SLIT-tablets to children with ARC in North America. Topics include a summary of the available SLIT-tablets and their efficacy and safety, guidance on when SLIT-tablets are an appropriate option, and how to diagnose ARC and identify culprit allergens. Practical guidance is also provided through a proposed decision tree, a prescribing checklist and prescribing procedures, and suggested follow-up assessments.

Keywords: allergen immunotherapy; allergic rhinitis; checklist; children; decision tree; management; sublingual.

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Conflict of interest statement

MB has served as a consultant or speaker for ALK, Sanofi, Regeneron, Merck, Bellus, Hikma, Prollergy, and Lanier Biotherapeutics. LD has served as a consultant or speaker for ALK, Sanofi, Regeneron, Allergy Therapeutics, GSK, AstraZeneca, and Abionic. HN and MO are employees of ALK. KR was an employee of ALK when the work was conducted.

Figures

Figure 1
Figure 1
Decision tree for pediatricians between offering SLIT-tablets or referring to an allergy specialist. ARC, allergic rhinoconjunctivitis; Der f, Dermatophagoides farinae; Der p, Dermatophagoides pteronyssinus; HDM, house dust mite; sIgE, allergen-specific immunoglobulin E; SLIT, sublingual immunotherapy.
See this image and copyright information in PMC

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References

    1. García-Marcos L, Asher MI, Pearce N, Ellwood E, Bissell K, Chiang CY, et al. The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study. Eur Respir J. (2022) 60:2102866. 10.1183/13993003.02866-2021 - DOI - PMC - PubMed
    1. Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the pediatric allergies in America survey. J Allergy Clin Immunol. (2009) 124:S43–70. 10.1016/j.jaci.2009.05.013 - DOI - PubMed
    1. Meltzer EO, Farrar JR, Sennett C. Findings from an online survey assessing the burden and management of seasonal allergic rhinoconjunctivitis in US patients. J Allergy Clin Immunol Pract. (2017) 5:779–89.e6. 10.1016/j.jaip.2016.10.010 - DOI - PubMed
    1. Fereidouni M, Rezapour H, Saharkhiz M, Mahmoudzadeh S, Ayadilord M, Askari M, et al. A study of the association of cognitive abilities and emotional function with allergic disorders in young women. BMC Womens Health. (2021) 21:205. 10.1186/s12905-021-01345-x - DOI - PMC - PubMed
    1. Papapostolou G, Kiotseridis H, Romberg K, Dahl Å, Bjermer L, Lindgren M, et al. Cognitive dysfunction and quality of life during pollen season in children with seasonal allergic rhinitis. Pediatr Allergy Immunol. (2021) 32:67–76. 10.1111/pai.13328 - DOI - PMC - PubMed

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