Las tabletas de inmunoterapia sublingual frente a ácaros en el asma bronquial alérgica
Resumen
La inmunoterapia específica con alérgenos se comenzó a utilizar de forma empírica hace más de 100 años, consolidándose la administración por vía subcutánea. Actualmente es una opción de tratamiento para la patología alérgica respiratoria y es complementaria a la farmacoterapia convencional. La vía sublingual surgió cuando aparecieron dudas sobre la seguridad de la vía subcutánea. A lo largo de las décadas, la mayoría de los productos de inmunoterapia específica con alérgenos se han comercializado sin ser evaluados en ensayos clínicos apropiados. En las últimas décadas, se ha producido un desarrollo impresionante de la inmunoterapia sublingual, con una clara mejoría de la eficacia, seguridad y papel de las preparaciones alergénicas estandarizadas. Así, las tabletas de inmunoterapia sublingual son formulaciones orales estandarizadas y bien caracterizadas que han sido evaluadas en ensayos clínicos y aprobadas por las agencias reguladoras de los países en los que se han comercializado. En esta revisión nos vamos a centrar en las tabletas de inmunoterapia sublingual frente a ácaros del polvo doméstico, que son las únicas que han probado su eficacia en los pacientes con asma alérgica, demostrando reducción en las agudizaciones y en el uso de corticoides inhalados y se recomiendan en las principales guías de asma. Además, este tratamiento es bien tolerado y compatible con la administración domiciliaria, por lo que evita asistencias al centro sanitario, lo cual es un dato importante en esta época actual de covid-19, que nos está obligando a la reorganización de los sistemas sanitarios para una adecuada asignación de los recursos.
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