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Background: Allergic rhinitis (AR) is a very common debilitating disease that can be detrimental to one’s lifestyle, work, and home life. Immunotherapy is the only treatment option that has disease modifying capabilities with a proper therapeutic regimen. Subcutaneous immunotherapy (SCIT) was developed over 100 years ago and has been the gold standard in immunotherapy for many years in the United States. During these years many adverse reactions have been reported with SCIT along with non-adherence to total treatment. The introduction of sublingual immunotherapy (SLIT) over 20 years ago gave providers a promising alternative to SCIT.

Method: A review of literature was performed to gain information on studies comparing SLIT to SCIT for treating allergic rhinitis. This review includes head to head clinical outcomes from systematic reviews and meta-analyses. Efficacy, cost, adherence, and adverse reactions was analyzed between SLIT and SCIT to determine if SLIT is a practical treatment option.

Results: The results indicate that treatment with SLIT is comparable to SCIT. SLIT significantly reduces the symptoms of AR with -0.49 SMD and SCIT with -0.73 SMD. Both SCIT and SLIT are generally safe medications when administered properly. SCIT demonstrates a higher risk of systemic reactions with anaphylaxis occurring 0.72% versus 0.33% in placebo. Comparative data shows that SLIT is an effective alternative to SCIT and has equivalent to better adherence to treatment.

Application: It is important for providers to understand the detrimental effects of AR and treat the disease process aggressively. AR may be commonly misdiagnosed, so understanding the disease process and how it can mimic others will promote better treatment outcomes and patient satisfaction. Ideally, SLIT will be seen as a viable option compared to SCIT for treating allergic rhinitis in patients where symptomatic treatment options do not suffice.


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

First Advisor

Terri Wold

Publication Date



Allergens -- therapeutic use; Rhinitis, Allergic -- drug therapy; Sublingual Immunotherapy; Treatment Outcome; Comparative Study


Allergy and Immunology

Sublingual Immunotherapy: Is it a Viable Option to Subcutaneous Immunotherapy when Treating Allergic Rhinitis?