Comparison of subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in allergic rhinitis and allergic asthma

Perek A, Raszewska J, Jabłoński W, et al. Alergologia Polska - Polish Journal of Allergology. 2026. doi:10.5114/pja.2026.164983.

Abstract

Allergic rhinitis and allergic asthma are among the most prevalent chronic diseases, significantly impairing patients’ quality of life and generating substantial healthcare costs. Allergen immunotherapy (AIT), administered as subcutaneous (SCIT) or sublingual (SLIT) immunotherapy, remains the only treatment capable of modifying the natural course of allergic disease. The aim of this study was to compare the clinical efficacy, safety profile, adherence, and economic aspects of both AIT modalities based on current evidence. A narrative review of randomised clinical trials, meta-analyses, observational studies, and pharmacoeconomic analyses was conducted, with particular emphasis on treatment effectiveness, safety, adherence, and direct and indirect healthcare costs.

Both SCIT and SLIT demonstrate significant efficacy in reducing allergic symptoms and the need for symptomatic medication, with a documented disease-modifying effect, including reduction of asthma risk in patients with allergic rhinitis. SCIT has a longer history of use and a broader body of evidence supporting efficacy, whereas SLIT is characterised by a more favourable safety profile and greater treatment convenience. Real-world studies indicate that adherence remains one of the most important determinants of long-term clinical effectiveness for both modalities. Pharmacoeconomic analyses confirm that both SCIT and SLIT are cost-effective compared with symptomatic treatment alone, although their cost structures differ with regard to medication costs, healthcare resource utilisation, and indirect costs associated with work productivity loss and medical visits. The choice of AIT modality should therefore be individualised according to patient characteristics, disease profile, safety considerations, and healthcare organisational factors.

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