In Reply We agree with Dr Frati and colleagues regarding the need for higher dosing
with sublingual immunotherapy than subcutaneous immunotherapy. Although there are anecdotal reports
of clinical use of sublingual immunotherapy in the United States, to our knowledge, there have been
no published surveys of the dosing used by these physicians.
Frati and colleagues are correct that we did not report the ratio of sublingual to subcutaneous
immunotherapy in our review, which is a useful comparator. However, this same information can be
derived by using the micrograms per month of major allergen used in each study, which was included
when available for each article in the supplementary materials.
Lin SY, Suarez-Cuervo C, Segal J. Efficacy of Sublingual Immunotherapy—Reply. JAMA. 2013;310(6):644-645. doi:10.1001/jama.2013.7652