Sublingual Versus Subcutaneous Immunotherapy for Allergic Rhinitis: What Are the Important Therapeutic and Real-World Considerations?

Curr Allergy Asthma Rep. 2020 Jun 16;20(9):45. doi: 10.1007/s11882-020-00934-4.


Purpose of review: Allergen immunotherapy has been used for over 100 years in the treatment of allergic rhinitis. With two major options for administering this disease-modifying therapy, SCIT, and SLIT, what is our current understanding of the efficacy and safety of each one? How do we determine who is the appropriate candidate for each one in the real world?

Recent findings: SCIT and SLIT show significant improvement in clinical symptoms and need for medication in the treatment of allergic rhinitis. In recent meta-analyses, there is no significant difference in the efficacy between the two treatments, but SLIT has more local side effects though less systemic ones. Shared decision-making should be instituted to determine which treatment should be started in a patient with allergic rhinitis. This review provides up-to-date information on the efficacy and safety of SCIT vs SLIT in the care of children and adults with allergic rhinitis in the real world and the role of shared decision-making in the use of these modalities.

Trial registrations: NCT04145219 and NCT02478398.

Keywords: Allergen immunotherapy; Allergic rhinitis; Shared decision making; Subcutaneous immunotherapy; Sublingual immunotherapy.

Publication types

  • Review

MeSH terms

  • Desensitization, Immunologic / methods*
  • Humans
  • Injections, Subcutaneous / methods*
  • Rhinitis, Allergic / etiology
  • Rhinitis, Allergic / immunology
  • Rhinitis, Allergic / therapy*
  • Sublingual Immunotherapy / methods*

Associated data