Sublingual immunotherapy in the treatment of allergic diseases in children: practical guidance for primary care physicians and paediatricians

Abstract

The prevalence of allergic diseases in children has been steadily increasing, representing a significant diagnostic and therapeutic challenge for primary care physicians and paediatricians. The most common allergic conditions in childhood include allergic rhinitis, allergic conjunctivitis, and asthma. These diseases can significantly impair a child’s quality of life, as well as their school performance and social functioning. The cornerstone of management remains allergen avoidance and symptomatic treatment. In patients whose symptoms persist despite optimal pharmacotherapy, allergen-specific immunotherapy should be considered, as it represents the only causal treatment for allergic diseases. Sublingual immunotherapy is a modern and widely used form of allergen immunotherapy, characterised by a high safety profile, good tolerability, and clinical efficacy. Sublingual immunotherapy can modify the natural course of allergic diseases, lead to symptom reduction, decrease the need for symptomatic medication, and potentially reduce the risk of asthma development and new sensitisations. Because it can be administered at home, sublingual immunotherapy is particularly advantageous in the paediatric population. The aim of this paper is to provide practical guidance for primary care physicians and paediatricians regarding patient qualification for sublingual immunotherapy, principles of treatment management and monitoring, recognition of adverse effects, and situations requiring temporary treatment interruption. Furthermore, the importance of close collaboration between primary care physicians, paediatricians, and allergists is emphasised to ensure the efficacy, safety, and appropriate delivery of long-term allergen immunotherapy.