World Allergy Organization (WAO)
Convenes Global Meeting on Sub-Lingual Immunotherapy
Delivery of immunotherapy by the sub-lingual (SLIT) route is an exciting therapeutic strategy, gradually being adopted throughout the world. It is, therefore, essential that the global allergy community establishes the facts about the use, the safety, and the limitations of this therapeutic modality, and speaks with one voice on this important issue.
WAO invited its 77 Regional, National and Affiliate Member Societies to participate in a meeting in Paris, 22-23 January 2009, to develop a consensus to be published as the first global Position Statement on SLIT. To enable WAO to capture a truly global perspective, general practitioner and patient groups were invited to join other NGOs at the WAO table; participants included Allergic Rhinitis and Its Impact on Asthma (ARIA), European Federation of Allergy and Airway Diseases Patients Association (EFA), International Primary Care Respiratory Group (IPCRG), Global Allergy and Asthma European Network (GA2LEN), and the National Institutes of Health (NIH). The meeting was chaired by WAO President, Professor G. Walter Canonica, with Co-Chairs Dr. Richard F. Lockey (President-Elect, WAO), Professor Jean Bousquet (Secretary General, WAO) and Dr. Thomas B. Casale (WAO Board Member-at-Large).
To optimize discussion, an international group of contributing authors prepared a draft Position Statement, which was shared with all participants prior to the meeting and provided the focus for the discussion during the meeting. The draft Position Statement reviewed and discussed at the meeting covered major aspects of SLIT, starting with the historical background. Other key issues included:
- Allergen specific immunotherapy (Update on SCIT, other routes, different allergens, impact on natural history)
- Mechanisms of SLIT
- Efficacy of SLIT
- Safety of SLIT including grading system
- Impact on natural history; Guidelines on SLIT
- SLIT in children
- Unmet needs and the concept of Severe Chronic Upper Airway Diseases
- Definition of SLIT patient selection
- Clinical trial methodology
- The future of Immunotherapy in the Community Care setting.
Lively and engaged discussion centered on highlights from these sections. The geographic diversity and different medical background of participants ensured varied feedback and provided important perspectives. For example, it became clear that there is an urgent need for comprehensive patient education about how to manage SLIT administration at home, what medical situations would contraindicate taking the next scheduled dose, and what to do in the case of missed doses.
The resulting documents comprising the Position Statement will be published in The World Allergy Organization Journal, Journal of Allergy and Clinical Immunology, and Allergy. Moreover, the findings of the meeting will be presented at the 2nd International Immunotherapy Day during World Allergy Congress (WAC), Buenos Aires, Argentina, 6-10 December 2009.