Efficacité de l’immunothérapie dans l’asthme : comparaison des voies sous-cutanée et sublinguale☆
(2009) Revue Francaise d’Allergologie — Vol. 49, n° 6, p. 481-486 (2009)
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- Allergen-specific immunotherapy (IT) represents an effective treatment in allergic asthma and rhinitis. Seven studies have directly compared the sublingual route (SLIT) to conventional, subcutaneous IT (SCIT). The efficacy of SCIT versus SLIT on asthma and rhinitis symptom and medication scores was not significantly different, although a tendency for greater benefit with SCIT was often reported. Comparison of SCIT and SLIT meta-analyses confirmed this trend, except that the effect of SLIT seemed to increase over time. Improved lung function and bronchial reactivity threshold were observed in some but not all studies of SCIT and SLIT. The long term benefit documented for two to three years of SCIT needs to be confirmed for SLIT, assuming that both treatments probably affect the natural course of these patients toward polysensitization and (in pollen allergy) the development of asthma. The most striking difference between SCIT and SLIT is the risk of a severe allergic reaction to the vaccine, which is limited to SCIT, limiting its benefit/risk ratio in chronic asthma. Before additional comparative data are available, the choice of SCIT versus SLIT should rely on the assessment of the balance of efficacy over risk, taking into account the documented effects of these treatments and the patient's phenotype. (C) 2009 Elsevier Masson SAS. All rights reserved.
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Pilette, C. (2009). Efficacité de l’immunothérapie dans l’asthme : comparaison des voies sous-cutanée et sublinguale☆. Revue Francaise d’Allergologie, 49(6), 481-486. https://doi.org/10.1016/j.reval.2009.02.012 (Original work published 2009)