[Status and indications for SLIT in comparison to SCIT]

Area of Science:

• Allergy and Immunology
• Immunotherapy Research

Background:

• Specific immunotherapy (SCIT and SLIT) efficacy relies on precise diagnosis, allergen identification, and risk assessment.
• Standardized, high-quality allergen extracts with proven efficacy are crucial for both SCIT and SLIT.

Purpose of the Study:

• To evaluate and compare the efficacy and indications for Subcutaneous Immunotherapy (SCIT) and Sublingual Immunotherapy (SLIT).
• To provide guidance on selecting the most appropriate allergen immunotherapy based on available evidence and patient factors.

Main Methods:

• Review and comparison of existing scientific literature and guidelines regarding SCIT and SLIT.
• Analysis of comparative effectiveness data, considering factors like allergen extract quality and clinical trial evidence.
• Evaluation of societal recommendations (e.g., German Allergy Society vs. European Society).

Main Results:

• Significant variability exists between different SCIT and SLIT extracts, necessitating product-specific evaluation.
• Evidence suggests SCIT demonstrates more robust long-term and preventive effects (e.g., asthma development, new sensitizations) compared to SLIT.
• Societal comparisons show differing views, with the German Allergy Society's assessment of SLIT being less favorable than the European Society's.

Conclusions:

• In the absence of direct high-quality comparative data, high-quality SCIT is recommended over SLIT.
• SCIT offers more satisfactory demonstrated long-term and preventive benefits.
• High-quality SLIT may be a suitable alternative for adult rhinoconjunctivitis patients unable to undergo SCIT.