American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 30, Issue 5 , Pages 305-311, September 2009

Quality of life outcomes with sublingual immunotherapy☆☆☆★

  • Sarah K. Wise, MD

      Affiliations

    • Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
    • Department of Otolaryngology – Head and Neck Surgery, The Emory Clinic, Atlanta, GA, USA
    • ,
  • Jamie Woody, PA-C

      Affiliations

    • Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
    • ,
  • Sarah Koepp, PA-C

      Affiliations

    • Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
    • ,
  • Rodney J. Schlosser, MD

      Affiliations

    • Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
    • Corresponding Author InformationCorresponding author. Medical University of South Carolina, Department of Otolaryngology – Head and Neck Surgery, 135 Rutledge Ave, Suite 1130, PO Box 250550, Charleston, SC 29425. Tel.: +1 843 792 7165; fax: +1 843 792 0546.

Received 27 February 2008 published online 09 February 2009.

Abstract 

Purpose

Immunotherapy is the titrated exposure of allergens to induce immunologic tolerance and offers long-term immune modification. Traditional subcutaneous immunotherapy (SCIT) has resulted in several deaths and raised safety concerns. Sublingual immunotherapy (SLIT) is an alternative administration route for allergen-specific immunotherapy. Compared to SCIT, SLIT has a shorter escalation phase, equal or greater efficacy for rhinitis, and an improved safety profile. The purpose of this study was to evaluate quality of life measures in a preliminary patient sample initiating SLIT at our institution.

Materials and methods

Patients with appropriate allergen reactivity were given the option to pursue immunotherapy by traditional SCIT or by SLIT techniques. Patients choosing SLIT completed the mini-Rhinoconjunctivitis Quality of Life Questionnaire (m-RQLQ), a 14-item Likert-type questionnaire, at baseline and during maintenance therapy. Patients typically reached maintenance dosing in less than 5 weeks.

Results

Paired m-RQLQ data were available for 15 patients after antigen titration. Initial m-RQLQ results indicate statistically significant (P < .05) improvement on 12 of 14 domains, including impact on regular and recreational activities, sleep, nose rubbing and nose blowing, stuffy nose and runny nose, itchy eyes, sore eyes, watery eyes, thirst, and tiredness. In addition, total m-RQLQ score showed statistically significant improvement (P = .001). No serious adverse events occurred with the initiation of SLIT.

Conclusion

These results indicate that SLIT is effective in controlling allergic symptoms and is safe in an introductory patient sample. Double-blind placebo-controlled trials are needed to confirm our preliminary results.

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☆ Presented at the spring meeting of the American Rhinologic Society, San Diego, CA, April 27, 2007.

☆☆ Dr Wise has received grant support from XoranTech, Inc., Ann Arbor, MI; Acclarent, Inc., Menlo Park, CA; NeilMed Pharmaceuticals, Inc., Santa Rosa, CA; Flight Attendants Medical Research Institute, Miami, FL; and Cystic Fibrosis Foundation, Bethesda, MD. Dr. Schlosser is a consultant or advisor for BrainLAB, Inc., Westchester, IL; Gyrus ACMI, Inc., Southborough, MA; Medtronic, Inc., Jacksonville, FL; and Schering Plough, Kenilworth, NJ. Dr Schlosser is on the speaker's bureau for GlaxoSmithKline, Brentford, Middlesex, UK. Ms Woody and Ms Koepp have no financial interests to declare. None of the above-noted financial interests had a direct impact on the design, data collection, data analysis, or interpretation performed in this study.

★ Approval for this study was granted by the Institutional Review Board of the Medical University of South Carolina HR16707, (Charleston, SC).

PII: S0196-0709(08)00116-6

doi:10.1016/j.amjoto.2008.06.003

American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 30, Issue 5 , Pages 305-311, September 2009

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