Evidence map›Paper›PMID 42835691›Full record

ReviewThe World Allergy Organization journal2026

World Allergy Organization Sublingual Immunotherapy Position Paper: 2026 update:

Giorgio Walter Canonica, Mário Morais-Almeida, Danilo Di Bona, Ignacio J Ansotegui, John J Oppenheimer, Maryam Al-Nesf, Jonathan A Bernstein, Davide Caimmi, Yoon-Seok Chang, Carla M Davis and 82 more

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Review in The World Allergy Organization journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

92 authors.

Giorgio Walter CanonicaPersonalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.
Mário Morais-AlmeidaAllergy Center, CUF Hospital Descobertas, Lisbon, Portugal.
Danilo Di BonaDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Ignacio J AnsoteguiDepartment of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Bilbao, Spain.
John J OppenheimerDivision of Allergy, Department of Medicine, UMDNJ - Rutgers University, Morristown, NJ, USA.
Maryam Al-NesfAllergy and Immunology Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.
Jonathan A BernsteinDepartment of Internal Medicine, Division of Rheumatology, Allergy and Immunology, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America.
Davide CaimmiAllergy Unit, University Hospital of Montpellier and IDESP, UMR 1318, University of Montpellier - INSERM, Montpellier, France.
Yoon-Seok ChangDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Carla M DavisHoward University College of Medicine, Washington DC, USA.
Motohiro EbisawaClinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Japan.
Alessandro FiocchiDivision of Allergy, Bambino Gesù Pediatric Hospital, IRCCS, Rome, Italy.
R Maximiliano GómezFaculty of Health Sciences, Catholic University of Salta, Salta, Argentina.
Sandra N González-DíazAllergy and Clinical Immunology Regional Center, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
Soon Jong HongUniversity of Ulsan College of Medicine, Ulsan, Republic of Korea.
Nikolaos G PapadopoulosAllergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
Ruby PawankarDepartment of Pediatrics, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
Jonny G PeterDivision of Allergy and Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
María Isabel Rojo GutiérrezUniversidad Tecnológica México, México City, Mexico.
Pongsakorn TantilipikornDivision of Rhinology and Allergy, Department of Otorhinolaryngology, Faculty of Medicine, Siriaj Hospital, Mahidol University, Bangkok, Thailand.
Johann Christian VirchowClinic for Pneumology, Allergology and Intensive Care, Department of Internal Medicine, University of Rostock, Rostock, Germany.
Gary Wk WongDepartment of Pediatrics, Chinese University of Hong Kong, Hong Kong.
Cherie Y ZacharyAllergy and Asthma Specialist, St. Paul, MN, USA.
Enrique Fernandez-CaldasInmunotek, S.L., Alcalá de Henares, Madrid, Spain.
Stephen R DurhamNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Abdullah A AlangariAllergy and Immunology Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Aksana IshchankaVitebsk State Medical University, Vitebsk, Belarus.
Amir Hamzah Abdul LatiffAllergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
An Soo JangDepartment of Internal Medicine, Soonchunhuyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
Ana MoreteAllergy Service, Hospital Infante D. Pedro, ULSRA, Aveiro, Portugal.
Andrzej BożekClinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland.
Anna H Nowak-WegrzynDepartment of Pediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, USA.
Anne K EllisDivision of Allergy & Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Carla IraniInternal Medicine & Clinical Immunology, Hotel Dieu de France Hospital, St. Joseph University, Beirut, Lebanon.
Carmen Bunu PanaitescuCenter for Gene and Cellular Therapies in Treatment of Cancer - OncoGen Center, Pius Brinzeu County Clinical Emergency Hospital, Timişoara, Romania.
Carmen RondónAllergy Unit, Malaga University Regional Hospital, Malaga, Spain.
Celia ZubrinichDepartment of Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.
Diego Betancourt SánchezAdvance Medical Center, Puerto Vallarta, Jalisco, Mexico.
Eloína González-ManceboDepartment of Allergy, University Hospital of Fuenlabrada, Rey Juan Carlos University, Madrid, Spain.
Emilia Maria Hidalgo CastroCentro de Asma y Alergia de México, México City, Mexico.
Evelyn Ng'ang'aPaediatric Allergy Center, Nairobi, Kenya.
Fares H ZaitounDivision of Allergy/Immunology, Clemenceau Medical Center, Dubai, United Arab Emirates.
Fátima Rodrigues FernandesDivision of Allergy and Immunology, Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil.
Hilary Dzigbodi AndohDepartment of Child Health, Greater Accra Regional Hospital, Accra, Ghana.
Hiroshi ChantaphakulDivision of Allergy and Clinical Immunology, Department of Medicine, Chulalongkorn University, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Igor KaidashevPoltava State Medical University, Poltava, Ukraine.
Iman NasrImmunology and Allergy, Royal Hospital, Muscat, Oman.
Herberto Chong-NetoDivision of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba, Brazil.
Celso PereiraMedicine Faculty, Coimbra University, Coimbra, Portugal.
Jean-Claude DorsainvilQueensland University, Grand'Anse, Dame-Marie, Jeremie, Haiti.
James M TracyDepartment of Pediatrics, University of Nebraska, College of Medicine, Omaha, NE, USA.
Jing LiDepartment of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Juan TrujilloDepartment of Pediatrics and Child Health, University College Cork, Cork, Ireland.
Kristina R JamalyanDepartment of Allergology and Immunology, Erebuni Medical Center, Yerevan, Armenia.
Krisztian GáspárDepartment of Dermatology, University of Debrecen, Debrecen, Hungary.
Luljeta AhmetajDepartment of Physiology and Immunology, Medical Faculty, Prishtina, Kosovo.
Margitta WormDivision of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Maria StaevskaDepartment of Allergy, University Hospital Alexandrovska, Medical University - Sofia, Sofia, Bulgaria.
Marina Atanasković-MarkovićDivision of Allergy, Department of Pediatrics, University Children's Hospital, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Maris BukovskisFaculty of Medicine and Life Sciences, University of Latvia, Riga, Latvia.
Marylin Valentin RostanAllergy Medical Institute, British Hospital, Montevideo, Uruguay.
Merzak GharnaoutDepartment of Allergy and Pulmonary Medicine, Béni-Messous University Hospital Center, University of Health Sciences, Algiers, Algeria.
Minoru GotohDepartment of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan.
Mona Al-AhmadDepartment of Microbiology, Kuwait University, Kuwait City, Kuwait.
Munkhbayarlakh SonomjamtsDepartment of Pulmonology and Allergology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
Komarla Nagendra PrasadBengaluru Allergy Centre, Bengaluru, India.
Olatunde OdusoteDepartment of Pediatrics, Lagos State University Teaching Hospital, Lagos, Nigeria.
Olga Patricia Monge OrtegaAllergy and Internal Medicine Clinic, CIMA Hospital, AlergoMed de Costa Rica, San José, Costa Rica.
Olympia TsilochristouAllergy Department, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
Pascal DemolyDivision of Allergy, University of Montpellier, Montpellier, France.
Peter StepaniukDivision of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Petr PanznerDepartment of Immunology and Allergology, Medical Faculty in Pilsen, Charles University Prague, Pilsen, Czechia.
Philip Hei LiDivision of Rheumatology & Clinical Immunology, Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong.
Raquel Aguilera-InsunzaAllergy and Immunology, Internal Medicine Department, Clínica Alemana de Santiago, Santiago, Chile.
Revaz SepiashviliClinical Immunolgy, National Institute of Allergology, Asthma and Clinical Immunology, Georgian National Academy of Sciences, Tskhaltubo, Georgia.
Riccardo AseroAmbulatorio di Allergologia, Clinica san Carlo, Paderno Dugnano, Milano, Italy.
Robin Ali Tarazona MartinezInmunocenter LAB, Clinica de Inmunologia y Alergias, Caracas, Venezuela.
Sabine AltrichterDepartment of Dermatology and Venerology, Kepler University Hospital, Linz, Austria.
Salina HusainDepartment of Otorhinolarynglogy - Head and Neck Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Sarah Jane KarabusDivision of Paediatric Allergy, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Silvia A UriarteDelgado Clinic, Lima, Peru.
Susana de BarayazarraAllergy and Immunology Service, National Hospital of Clinics, Córdoba, Argentina.
Syed Rezaul HuqDepartment of Respiratory Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Syed Shahid AbbasAllergy & Asthma Center, Islamabad, Pakistan.
Torsten ZuberbierInstitute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Umit Murat SahinerDepartment of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Türkiye.
Veridiana Aun Rufino PereiraDivision of Allergy and Immunology, Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil.
Vincenzo PatellaDivision of Allergy and Clinical Immunology, Department of Medicine, "S. Maria della Speranza Hospital", Salerno, Italy.
Violeta KvedarienėInstitute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Yuval TalDivision of Allergy and Clinical Immunology, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Zhanat IspayevDepartment of Allergology and Clinical Immunology, Asfendiyrov Kazakh National Medical University, Almaty, Kazakhstan.
Bryan L MartinDivision of Allergy and Immunology, Department of Otolaryngology, The Ohio State University, Columbus, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Sublingual immunotherapy (SLIT) is a well-established form of allergen immunotherapy with demonstrated efficacy and a favorable safety profile in IgE-mediated allergic diseases, particularly in allergic rhinitis and allergic asthma. Since the publication of previous World Allergy Organization (WAO) position papers, accumulating evidence and expanding global clinical experience has justified an updated, internationally harmonized framework to guide the appropriate use of SLIT across diverse healthcare settings. Methods: An international panel of experts developed an updated Position Paper on SLIT using a structured Delphi consensus methodology. Statements were formulated based on a targeted review of the scientific literature and expert clinical experience, addressing indications, patient selection, safety, treatment duration, adherence, biomarkers, disease modification, and implementation domains. Two rounds of anonymous electronic voting were conducted. Consensus was predefined as ≥70% agreement (scores 4-5 on a 5-point Likert scale). Results: Eighty-three experts representing all WAO regions were invited, and seventy-eight of them participated in the Delphi process. High levels of consensus were achieved for core principles, including SLIT effectiveness, safety, the importance of appropriate patient selection, a minimum treatment duration of 3 years, supervised administration of the first dose followed by home-based treatment, and the central role of adherence and regular follow-up. Consensus regarding disease-modifying effects was stronger for children and adolescents than for adults. Lower consensus was observed on topics related to regional allergens, likely influenced by differences in allergen exposure, product availability, clinical experience, and regulatory contexts; however, formal region-stratified analyses were not performed. Conclusions: This WAO Position Paper establishes a globally applicable, evidence-informed consensus framework for the positioning and implementation of SLIT. By clearly delineating areas of strong agreement and domains of conditional or context-dependent evidence, it provides both a clinical reference and a strategic roadmap for equitable and sustainable SLIT integration worldwide.

Indexed as

Allergen immunotherapyAllergic asthmaAllergic rhinitisConsensusDelphi techniqueDisease modificationIgE-mediated hypersensitivitySublingual immunotherapyTreatment adherenceWorld Allergy Organization

Identifiers

PMID42835691
PMCPMC13636449

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