Monoallergen Sublingual Immunotherapy Versus Multiallergen Subcutaneous Immunotherapy for Allergic Respiratory Diseases: A Debate During the AAAAI 2013 Annual Meeting in San Antonio, Texas

Abstract

4-7 At the AAAAI 2013 Annual Meeting in San Antonio, Texas, we debated the following issue: “Multiallergen subcutaneous allergen immunotherapy (SCIT) [defended by Linda S. Cox] is better than monoallergen sublingual allergen immunotherapy (SLIT) [defended by Moises A. Calderon].” After a brief introduction to the subject, we respectively consider clinical efficacy, indications, safety, immunology and regulatory and health economic issues for these 2 allergen immunotherapy (AIT) modalities, as embodied by our AAAAI 2013 debate. The present article is an account of a debate and does not constitute a systematic review of the literature. The reader is free to make up his or her mind on the basis of the opposing evidence presented by 2 experienced clinicians in San Antonio. Ever since the scientific reports of Noon and Freeman on clinically efficacious allergen immunotherapy (AIT) for grasspolleneinduced allergic rhinoconjunctivitis were published in The Lancet, physicians worldwide have administered a variety of AIT formulations to patients with one or more allergic conditions (notably allergic rhinitis [AR] and allergic asthma [AA]) induced by aeroallergens such as pollen and house dust mite (HDM) components. Although the efficacy of both SLIT and SCIT has been demonstrated in well-powered, double-blind placebo-controlled (DBPC) clinical trials and meta-analyses of