Guiding principles of sublingual immunotherapy for allergic rhinitis in Japanese patients

Keisuke Masuyama, Minoru Goto, Sachio Takeno, Nobuo Ohta, Mitsuhiro Okano, Atsushi Kamijo, Motohiko Suzuki, Tetsuya Terada, Daiju Sakurai, Shigetoshi Horiguchi, Kohei Honda, Shoji Matsune, Takechiyo Yamada, Masafumi Sakashita, Atsushi Yuta, Takashi Fuchiwaki, Ikuyo Miyanohara, Takeo Nakayama, Yoshitaka Okamoto, Shigeharu Fujieda

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Objective: Sublingual immunotherapy (SLIT) appears to offer practical advantages for the treatment of allergic rhinitis (AR). Based on a review of the scientific literature, we present recommendations as guiding principles to administer SLIT safely. Methods: Clinical questions concerning SLIT were prepared. Literature published between January 2003 and December 2012 was searched from PubMed, the Cochrane Library, and Japana Centra Revuo Medicina. Qualified studies were analyzed and the results were evaluated, consolidated, and codified. We answered 17 clinical questions and, based on this, presented evidence-based recommendations. Results: Sublingual immunotherapy improved symptoms (e.g., quality of life [QOL]) and reduced medication scores in seasonal AR and perennial AR. Most SLIT-induced adverse effects were local oral reactions, although systemic adverse effects such as gastrointestinal symptoms, urticaria, and asthma are occasionally reported. There have been no reports of lethal anaphylactic reactions by SLIT. When SLIT is continued for 3-years, its effect persists long after discontinuation. Conclusion: A correct diagnosis of AR and sufficient informed consent from patients are required before initiating SLIT. Sublingual immunotherapy should be continued for 3 years or longer. The initial administration of SLIT during the uptitration of an allergen vaccine and the general condition of patients are critical for the safe performance of SLIT.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalAuris Nasus Larynx
Issue number1
Publication statusPublished - Feb 1 2016


  • Allergic rhinitis
  • Guideline
  • Subcutaneous immunotherapy
  • Sublingual immunotherapy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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