期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
卷 5, 期 1, 页码 34-40出版社
ELSEVIER
DOI: 10.1016/j.jaip.2016.09.017
关键词
SLIT; Sublingual allergen immunotherapy; Safety of; Patient guidelines; Systemic allergic reactions
资金
- MEDECA Pharma AB
Liquid sublingual allergen immunotherapy (SLIT) has been used off-label for decades, and Food and Drug Administration (FDA)-approved grass and ragweed SLIT tablets have been available in the United States since 2014. Potentially life-threatening events from SLIT do occur, although they appear to be very rare, especially for FDA-approved products. Practice guidelines that incorporate safety precautions regarding the use of SLIT in the United States are needed. This clinical commentary attempts to address unresolved issues including controversy regarding the FDA mandate for the prescription of epinephrine autoinjectors for patients on SLIT; how to approach polysensitized patients; optimal timing and duration of SLIT administration; how to address gaps in therapy; whether antihistamines can prevent local reactions, if certain patient populations (such as persistent asthmatics) should not receive SLIT; and when to instruct patients to self-administer epinephrine. Key points are that physicians should focus on educating patients regarding: (1) when not to administer SLIT; (2) how to recognize a potentially serious allergic reaction to SLIT; and (3) when to administer epinephrine and seek emergency care. (C) 2016 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2017;5:34-40)
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