Which sublingual (SL) tablets have been approved for use in the treatment of pediatric allergic rhinitis?

Updated: Jun 04, 2021
  • Author: Jack M Becker, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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In April 2014, the FDA approved three SL tablets. Two are for grass allergies and the third is for ragweed. Oralair consists of five calibrated grass pollen extracts (Oralair). It contains Perennial Ryegrass (Lolium perenne), Kentucky bluegrass (Poa pratensis), Timothy grass (Phleum pratense), Orchard grass (Dactylis glomerata), and Sweet Vernal grass (Anthoxanthum odoratum). [11] The Oralair SL tablet needs to be initiated 4 months prior to the season for the specific allergen. It is approved for adults and children aged 5–65 years.

The second SL immunotherapy for grass is only one type of grass. Timothy grass (Grastek) was also approved in April 2014. It should be initiated at least 12 weeks before the start of the grass pollen season. [12] Efficacy and safety in North America was established in a large study (n=1500) of adults and children aged 5–65 years. Results showed a 23% improvement of symptoms in the entire grass pollen season. [13] Timothy grass cross-reacts with the following grasses, including sweet vernal, orchard (also known as cocksfoot), perennial rye, Kentucky blue (also known as June grass), meadow fescue, and redtop. This high cross-reactivity allows for Grastek to be effective for a patient with grass pollen allergies.

The third one is Ragwitek. Like the other two, it needs to be started prior to the onset of the season. It is a short ragweed extract (Ambrosia artemisiifolia) for adults aged 18–65 years.

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