Sublingual immunotherapy (SLIT) was developed to avoid the risk of severe systemic side effects which occur in subcutaneous
immunotherapy. Data from more than 20 controlled studies clearly show the efficacy and safety of this type of
immunotherapy in patients with allergic rhino-
conjunctivitis due to pollen and mites. The data for allergic
asthma still need confirmation. Sublingual immunotherapy is no substitute for subcutaneous
immunotherapy but an additional option for defined groups of patients. The application of a sufficient amount of
allergen is important for the efficacy of SLIT. According to the recommendation of the ARIA working group, a 50- to 100-fold cumulative dose should be applied as compared to subcutaneous
immunotherapy. SLIT can be used preseasonally, during the saison or perennially.
Therapy starts with a daily increase of the dose. In some cases, e. g., in adult patients with
pollen allergy, doses can be increased within hours. The well-tolerated maintenance dose should be taken three times a week or daily. The sublingual seasonal short-time
immunotherapy may become an additional option for subgroups of patients, e. g., for adolescents.