Specific immunotherapy with allergen mixes: what is the evidence?

The purpose is to review the published evidence for the use of multiallergen mixes in subcutaneous and sublingual immunotherapy.

Data are drawn from published articles and reviews, including a recent complete search of the English and non-English literature for publications on multiallergen immunotherapy.The problems arising from dilution of extracts and degradation of extracts resulting from adding additional extracts to a mixture are confirmed. The published literature of the use of multiallergen extracts in subcutaneous and sublingual immunotherapy indicates that multiallergen extracts are effective when given by injection, but a similar efficacy has not been established for them when administered sublingually.

Multiallergen extract mixes are probably effective for subcutaneous immunotherapy provided attention is paid to the concentration of each allergen in the mix and mixing of protease containing extracts with pollen and dander extracts is avoided. Further studies are needed to determine if multiallergen mixes are effective in sublingual immunotherapy.