While allergy shots can be a great way for patients to decrease their allergy symptoms and get long-lasting relief, they have an obvious downside. Getting poked with a needle, however small, isn’t exactly fun. Enter sublingual immunotherapy—an oral option approved for certain types of allergies. We sat down with Dr. Gregory Owens, an allergist and immunologist at Vancouver Clinic, to learn more about this approach.
Q: What is sublingual immunotherapy (SLIT) and how does it work?
Dr. Owens: Allergen immunotherapy is a method of decreasing a patient’s allergy symptoms through exposure to small amounts of the allergen over time. Traditionally, this has been done with allergy shots. Within the last five years, however, a new option has become available in the U.S. SLIT involves taking the allergens in a liquid or tablet form by mouth—usually on a daily basis.
Q: What allergies does this type of therapy address?
Dr. Owens: Currently, the U.S. Food and Drug Administration (FDA) has approved four allergy tablet products: Two are for different kinds of grass pollen, one is for dust mites, and one is for ragweed. One grass-pollen tablet addresses timothy grass pollen, the other grass-pollen tablet addresses five different types of northern grass pollen. For the most part, we don’t need the ragweed tablet in our clinic because there isn’t much ragweed pollen in the Northwest.
Q: How long does it take before patients start noticing a difference with their allergies?
Dr. Owens: Patients usually start noticing a response within three to four months. For our seasonal grass-allergic patients, we start this tablet in January so that it is effective by the time grass pollens are in the air. Patients typically take the tablets for three years and then stop.
Q: Who can choose this type of therapy?
Dr. Owens: SLIT is approved for adults and children over 5 years old. It’s not recommended for those with severe, poorly controlled asthma and those with eosinophilic esophagitis.
Q: What do the tablets taste like?
Dr. Owens: Essentially nothing. However, they often cause mild itchy mouth symptoms during the first few weeks of treatment.
Q: Are more sublingual options going to be available?
Dr. Owens: Hopefully! I’d expect that within the next few years the FDA will approve SLIT for some food allergies. Tablets for more environmental allergens will likely be developed as well.
Q: How do patients get started?
Dr. Owens: Make an appointment with one of our doctors in the Allergy, Asthma & Immunotherapy Department. We can discuss in more detail the benefits and downsides of this therapy, as well as all the other options we have. Call 360-882-2778 to schedule.