Real-Life Clinical Experience With SQ Grass, Tree, Ragweed, and House Dust Mite Sublingual Immunotherapy Tablets: A Review of Evidence From Non-Interventional Studies

Abstract

This review evaluates data from > 12,000 children, adolescents and adults (≥ 4 years) in non-interventional studies to assess the real-life effectiveness and safety of SQ sublingual immunotherapy (SLIT)-tablets for allergic rhinitis (AR). Non-interventional studies of SQ grass, tree, ragweed, and house dust mite (HDM) SLIT tablets were identified from PubMed (1 January 2006 to 11 February 2025) and supplemented by manual searches. Effectiveness was captured as patient-reported change in AR symptoms; AR and/or asthma medication use, safety and treatment satisfaction were also evaluated. In total, 12,136 participants were enrolled across 22 SQ SLIT tablet studies (grass: n = 6744; HDM: n = 4323; tree: n = 1069; ragweed: n = 102). Across studies, a high proportion of participants reported improvements from baseline or the previous season across nasal (up to 87%), ocular (up to 81%), and bronchial symptoms (up to 78%) with SQ SLIT tablets. Compared to baseline, a lower proportion of patients reported use of symptom-relieving medication, consistent across key drug classes including oral antihistamine, intranasal corticosteroids, short-acting beta-agonist, and inhaled corticosteroids. Discontinuations due to adverse events were low (0%-14.5%). Among studies reporting treatment satisfaction, 73%-96% of participants were found to be 'satisfied' or 'very satisfied' with this treatment. SQ SLIT tablets showed consistent effectiveness for AR, were well-tolerated, and were associated with a high degree of patient satisfaction. These real-life data from clinical practice are a valuable and important source of complementary evidence to the well established efficacy and safety from randomised clinical trials.

Keywords: allergen immunotherapy; allergic rhinitis; non‐interventional; real‐life effectiveness; sublingual immunotherapy (SLIT)‐tablet.