Latex sublingual immunotherapy: can its safety be predicted?

Background: Complete avoidance sometimes cannot be possible in latex-allergic health care workers. So far, very few double-blind placebo-controlled studies revealed the efficacy of sublingual latex immunotherapy (SLIT) in those patients. Objective: Our aim was to evaluate the efficacy and safety of latex SLIT in health care workers. Methods: 30 patients (all health care workers) diagnosed as latex allergic were advised to avoid latex exposure and were given information about the prevention measures and asked to return two months later. 24 patients who were still symptomatic despite prevention measures were informed about the latex SLIT study and asked to participate. However, only 12 gave approval and were randomized to receive sublingual latex extract or placebo. Symptom scores and latex cutaneous provocation test scores were recorded at baseline and at the 6th and 12th months of the study. Results: Two patients experienced anaphylaxis, 1 patient showed severe bronchial obstruction during dose incremental phase and were excluded from the study. The differences of the symptom and provocation scores between baseline and the 12th month of the treatment were significant in the active group (p = .042, p = .038, respectively). Also the symptom and provocation scores at 12 months were significantly lower in the active group than in the placebo group (p = .035, p = .013, respectively). Conclusion: Latex SLIT can be used as an effective treatment for latex-allergic health care patients having difficulties in applying adequate avoidance measures. However, the risk of systemic reactions should be kept in mind and sufficient precaution measures must be made available. Ann Allergy Asthma Immunol. 2010;104:339-342.