5.1.8. Allergen Immunotherapy
Allergen immunotherapy (AIT) is the only disease-modifying treatment
option for athletes suffering from AR, because of its capability to
induce immune tolerance leading to long term disease control76. Multiple studies have proven that AIT is effective
in reducing symptoms and rescue medication, as well as in improving QOL
in AR patients 76. AIT is administered either
subcutaneously (SCIT) or in a sublingual way (SLIT) with SCIT being
slightly more effective but SLIT showing a better safety profile. Both
types are permitted by the WADA regulations 61. SCIT
usually precludes performing exercise on the administration day, which
should be a factor to be considered in athletes.
A recent questionnaire-based study in athletes with AR, has indicated
that AIT had the most beneficial effect on AR symptoms with better
outcomes than classical pharmacological treatments 16.
Despite these positive AIT results, a post-hoc analysis showed that the
majority of athletes were not aware or had misbeliefs about this
treatment option.
Practically, it is recommended to start AIT a few months before the
competitive season because the initial phase can be accompanied with
local or systemic side effects, more so for SCIT than fore SLIT.