ArticleThe journal of allergy and clinical immunology. Global2026
Sublingual allergen immunotherapy in immunosuppressed rheumatoid arthritis patients: Safety and clinical outcomes.
Article in The journal of allergy and clinical immunology. Global, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Allergen immunotherapy (AIT) is an effective disease-modifying treatment for allergic rhinitis. However, autoimmune diseases such as rheumatoid arthritis (RA) are traditionally considered relative contraindications, and evidence on the safety and efficacy of AIT in patients receiving immunosuppressive therapy remains limited. Objective: We assessed the clinical efficacy, safety, and immunologic effects of sublingual immunotherapy (SLIT) for Japanese cedar pollen (JCP)-induced allergic rhinitis in patients with RA well controlled by stable immunosuppressive treatment. Methods: Six patients with RA in remission who also had moderate-to-severe JCP-induced allergic rhinitis were enrolled. SLIT began in September 2024 and continued for 1 year. Clinical efficacy was evaluated by the Japanese Rhinoconjunctivitis Quality of Life Questionnaire and daily medication scores during the peak pollen seasons in March 2024 and March 2025. RA disease activity, adverse events, and JCP-specific IgE and IgG Results: Despite a higher pollen load in 2025 compared with 2024, symptom scores showed a tendency toward improvement, and quality-of-life outcomes suggested potential clinical benefit. No RA flares were observed, and immunosuppressive therapy was not modified. Immunologic analyses demonstrated changes in JCP-specific IgE and IgG Conclusion: In this small cohort, SLIT for JCP was well tolerated and associated with potential clinical and immunologic benefits in patients with stable RA receiving immunosuppressive therapy. These findings support the possibility that AIT may be feasible in selected patients with autoimmune diseases.
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