Personalized Sublingual Immunotherapy Delivers Sustained Real-World Benefits: Insights from a Large Telemedicine Cohort Study

Sublingual immunotherapy (SLIT) has become an important disease-modifying option for IgE-mediated allergic rhinitis and related conditions. Unlike symptom-relief medications, SLIT works by repeatedly exposing the immune system to allergens placed under the tongue, gradually building tolerance and potentially providing lasting benefits after treatment ends.

A retrospective longitudinal cohort study published in Frontiers in Allergy (June 2026) examined real-world outcomes of personalized SLIT delivered through the telemedicine platform Curex. The analysis included 2,897 adults who received custom-formulated sublingual drops based on their individual allergen sensitivities (most commonly dust mites, cat and dog dander, and pollens) and had at least 12 months of treatment with follow-up data. Median follow-up was 20 months.

Patients showed meaningful clinical improvements. Symptom severity scores (0–100 scale) dropped by an average of 10.1 points in the first six months, with continued gains thereafter. The proportion achieving clinically meaningful improvement (≥30-point reduction) increased from 28% at 12 months to 45% at 24 months. Allergy medication use declined steadily, with growing numbers of patients reporting substantial reductions. Quality-of-life improvements were reported by over 90% of participants in longer-term follow-up. Adherence was high, with more than 90% using the drops on at least 20 days per month. The safety profile was excellent: adverse events occurred in only 11.7% of patients and were predominantly mild (Grade 1 local reactions); no anaphylaxis or eosinophilic esophagitis was reported. Among the 25% of patients with comorbid asthma, treatment was associated with better symptom control and reduced rescue inhaler use.

These findings demonstrate that telemedicine-enabled, personalized SLIT can overcome common barriers of access and adherence while delivering sustained symptom relief, reduced medication dependence, and a favorable safety profile in routine clinical practice. As allergy prevalence continues to rise, scalable models combining personalization with remote care offer a practical path to broader use of disease-modifying immunotherapy.