When most people hear the word “immunotherapy,” they think of allergy shots. While allergy shots are the most common form of immunotherapy used today, the first known allergy desensitization treatment was done by mouth over 114 years ago. A physician in New York would administer pollen antigen drops into his patients’ mouths to treat hay fever. For many years allergy drops, also known as SLIT (Sublingual Immunotherapy), were the only known way to treat patients for their allergens.
Eleven years later, an English physician began treating hay fever by injecting his patients with pollen extracts; this is what we now know as allergy shots or SCIT (Subcutaneous Immunotherapy). Over the years both shots and drops have been used for immunotherapy, with shots eventually becoming the favored treatment type. As time has passed and studies have shown the effectiveness of both shots and drops, more and more allergy offices are bringing allergy drops back into their practice. At Central Oregon Ear, Nose & Throat, we offer both SCIT and SLIT treatment.
Research has shown that sublingual drops are a safe, effective form of immunotherapy. Just like with injections, patients undergoing SLIT therapy are given a very low initial dose that is gradually increased until the patient reaches a therapeutic dose level(commonly called the “maintenance dose”). The patient will remain on the maintenance dose for 3-5 years, when immunity to the allergens has been reached and symptoms have dissipated. Clinical improvement is usually observed within 3-6 months of initiating treatment.
Along with being safe, there are many advantages to SLIT therapy. Time saved on visits to our office is a benefit to those with busy schedules. With SLIT, patients will only need to come into the office every three weeks for the first three months, followed by once every three months for the remainder of the length of immunotherapy. SLIT is also a preferred treatment for those with an aversion to injections, such as children. Research has found that SLIT is especially helpful to infants and children with eczema, recurrent ear infections, asthma, chronic sinusitis, and multiple allergies.
Although SLIT is a common form of treatment used all over the world, it has not yet been approved by the FDA in the United States and is considered “off-label.” Off-label use of medication is not uncommon; however, it is not covered by insurance.
Despite this, there are significantly fewer office visits and copays compared to SCIT, which can calculate out to SLIT having a lower overall cost. In addition, our office is able to submit claims to the insurance companies for the office visits, and SLIT is reimbursable through “Flex-spending” accounts. If you decide immunotherapy is a route you would like to take we can compare the costs and other factors of SLIT and SCIT and find the right treatment plan for you.
Central Oregon Ear, Nose & Throat
2450 NE Mary Rose Pl., Ste 120, Bend
541-382-3100
www.coent.com
