Febbraio 2006 - Volume XXV - numero 2

Medico e Bambino


Farmacoriflessioni

L’immunoterapia sublinguale può sostituire quella iniettiva nel trattamento delle malattie allergiche respiratorie?

DANIELE RADZIK

UO di Pediatria, Ospedale di Castelfranco Veneto (TV)

CAN SUBLINGUAL IMMUNOTHERAPY SUBSTITUTE SUBCUTANEOUS INJECTIVE IMMUNOTHERAPY FOR THE TREATMENT OF RESPIRATORY ALLERGIC DISEASES?

Key words: Sublingual immunotherapy, Subcutaneous injective immunotherapy, Randomised controlled trials

Subcutaneous injective immunotherapy (SCIT) has been used for almost 100 years for the treatment of respiratory allergic diseases, with many data available on this topic. SCIT remains however rather controversial because, even if its effects persist after its discontinuation, there is no evidence that the natural history of the disease could be modified in adulthood. Moreover SCIT does not provide any additional clinical advantage when associated to a correct pharmacological treatment. Therefore the decision to start this type of therapy should be taken evaluating the risk-cost/benefit ratio of each single patient. In order to provide a more comfortable use and enhanced safety, sublingual immunotherapy (SLIT) was recently developed and is now commonly adopted, although its clinical efficacy in particular in comparison to SCIT is not fully established. To tackle this issue, all randomized controlled trials comparing SLIT vs SCIT were reviewed. Three trials conducted in adult populations were identified and they demonstrated the equivalence of SLIT vs. SCIT. However, only one trial had appropriate randomization while the other 2 had uncertain treatment allocation. Hence, the validity of the results is questionable given the significant methodological biases found.

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D. Radzik
L’immunoterapia sublinguale può sostituire quella iniettiva nel trattamento delle malattie allergiche respiratorie?
Medico e Bambino 2006;25(2):104-110 https://www.medicoebambino.com/?id=0602_104.pdf


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