May 2014 update on sub-lingual immunotherapy (SLIT)

May 16th, 2014

The FDA has recently approved 3 products for use as SLIT in the US market. 2 products treat grass pollen allergy: Oralair (Stallergenes/Greer) and Grastek (ALK/Merck). 1 product treats ragweed allergy: Ragwitek (Merck). As mentioned in the last AAC blog post, SLIT for grass is relevant in the Rogue Valley whereas SLIT for ragweed is not (based on our local aerobiology).
Treatment for grass pollen allergy with SLIT is best accomplished by beginning treatment at least 3 months prior to the onset of grass season. We typically see grass pollen on the Rotorod sampler at our Medford office in early May each spring. 2014 has been an atypical year with less rain in the valley and less snow in the surrounding Cascades/Siskiyous–and we observed an earlier onset of grass pollinosis beginning the second week of April. We anticipate further escalation of grass pollen counts as we progress through May and June, with resolution in July. Future grass SLIT treatments will be most effective by starting therapy in January for individuals who are primarily sensitized to grass.
We recommend evaluation by an allergist for testing and to discuss all treatment options, including SLIT. The FDA has recommended (and the package inserts specify) that the first SLIT dose should be delivered in an office with trained immunotherapy personnel (i.e. an allergist’s office).
We are excited about this new development in allergy and immunology!
Kevin Parks MD