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Related Concept Videos

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Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
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Related Experiment Video

Updated: Dec 9, 2025

Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
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Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections

Published on: August 30, 2014

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Sublingual immunotherapy for asthma.

Rebecca Fortescue1, Kayleigh M Kew2, Marco Shiu Tsun Leung3

  • 1Cochrane Airways, Population Health Research Institute, St George's, University of London, London, UK.

The Cochrane Database of Systematic Reviews
|September 14, 2020
PubMed
Summary
This summary is machine-generated.

Sublingual immunotherapy (SLIT) for asthma shows potential safety but lacks conclusive evidence on efficacy for reducing exacerbations and improving quality of life. Further research is needed for uncontrolled asthma cases.

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Area of Science:

  • Allergy and Immunology
  • Respiratory Medicine
  • Clinical Trials

Background:

  • Asthma affects 300 million globally, with allergies implicated in half of cases, suggesting targeted treatments like sublingual immunotherapy (SLIT) could be beneficial.
  • SLIT involves administering increasing allergen doses under the tongue to induce immune tolerance, aiming to reduce asthma symptoms.

Purpose of the Study:

  • To evaluate the efficacy and safety of sublingual immunotherapy (SLIT) compared to placebo or standard care in adults and children with asthma.
  • To synthesize evidence from randomized controlled trials on SLIT's impact on asthma exacerbations, quality of life, and adverse events.

Main Methods:

  • Systematic review and meta-analysis of parallel randomized controlled trials (RCTs) including adults and children with asthma, with data updated to October 2019.
  • Primary outcomes included asthma exacerbations, quality of life, and serious adverse events (SAEs); secondary outcomes included symptom scores and medication use.
  • GRADE approach was used to assess the certainty of evidence for all outcomes.

Main Results:

  • Sixty-six studies were included; most were placebo-controlled trials in mild-to-moderate asthma, often with allergic rhinitis.
  • Evidence for SLIT reducing asthma exacerbations requiring emergency care is very uncertain (very low-certainty evidence).
  • SLIT likely does not increase serious adverse events (moderate-certainty evidence), but non-serious adverse events were more frequent (high-certainty evidence).
  • Data on quality of life and symptom scores were limited or used non-validated scales, hindering definitive conclusions.

Conclusions:

  • Current evidence on SLIT's efficacy for key asthma outcomes like exacerbations and quality of life is limited, preventing clinically useful conclusions.
  • SLIT appears to be a safe option for mild-to-moderate asthma with allergic rhinitis, but its role in uncontrolled asthma requires further investigation.
  • Limitations include infrequent reporting of primary outcomes, selective reporting, and methodological biases in many included trials.