Current Specific Immunotherapy for Allergic Rhinitis: Perspectives from Otorhinolaryngologists

273 http://e-aair.org The prevalence of allergic rhinitis (AR) in the general population is increasing and currently estimated to be approximately 10-25%. Although AR is not associated with a risk of death, the disorder can have a considerable effect on a patient’s quality of life. Consideration of comorbid diseases, including asthma, nasal polyp, olfactory dysfunction and chronic rhinosinusitis, results in a tremendous increase in the medical cost for AR treatment, which has come to entail more than just treating the rhinitis itself. Among the current treatment options for AR, specific allergen immunotherapy (SIT) is the only medical intervention that modifies fundamental immunologic mechanisms by inducing tolerance, and it can also modify the natural course of the disease. SIT for AR has been used for more than a century since first reported by Noon. SIT refers to the repeated administration of allergenic extracts to atopic individuals over a period of 3 to 5 years either subcutaneously (SCIT) or sublingually (SLIT) for the treatment of allergic diseases. At first, SCIT was used for allergic diseases caused by pollen allergens, such as hay fever or seasonal AR; however, today the indications extend to hymenoptera venom, house dust mites (HDMs), animal dander and allergic diseases related to fungi. SCIT has been demonstrated to be effective for asthma and AR; yet, it has several disadvantages, such as its inconvenience, invasiveness and potentially severe systemic reactions. Thus, SLIT has recently received much attention around the world as a primary treatment for AR and is now widely used as a replacement for subcutaneous administration, even in Korea. The efficacy and safety of SIT have been established by many clinical trials, studies, and meta-analyses, and its long-term effects and prevention of asthma progression have been suggested. In the Asia-Pacific region, the majority of patients with AR are diagnosed by ENT specialists or general practice physicians. Published data suggest that ENT specialists most commonly Current Specific Immunotherapy for Allergic Rhinitis: Perspectives from Otorhinolaryngologists Chae-Seo Rhee