NICE updated recommendation for Itulazax for treating moderate to severe allergic rhinitis or conjunctivitis caused by tree pollen – Alk‑Abello

NICE(UK) updated recommendation their 6 August 2026 recommendation to expand the population in line with the marketing authorisation. We also updated the technology name and title to more closely reflect the marketing authorisation. 

12 standardised quality betula verrucosa pollen sublingual lyophilisate (12 SQ-Bet SLIT) can be used, within its marketing authorisation, as an option to treat moderate to severe allergic rhinitis or conjunctivitis caused by pollen from the birch homologous group of trees in people aged 5 years and over with: i) symptoms despite using symptom-relieving medicines; ii) a positive sensitisation test (skin prick test or specific immunoglobulin E) to a member of the birch homologous group. Why this recommendation was made: Usual treatment for moderate to severe allergic rhinitis and conjunctivitis caused by pollen from the birch homologous group of trees includes symptom-relieving medicines such as antihistamine tablets and corticosteroid nasal sprays. It may also include subcutaneous immunotherapy if people have symptoms despite using symptom-relieving medicines. Clinical-trial evidence shows that 12 SQ-Bet SLIT, a sublingual immunotherapy, reduces the severity of allergic rhinitis and conjunctivitis symptoms compared with placebo (both with symptom-relieving medicines). There is no direct evidence comparing 12 SQ-Bet SLIT with subcutaneous immunotherapy, but clinical expert opinion is that they may have similar effectiveness. There are uncertainties in the economic modelling, including how many healthcare appointments would be saved by using 12 SQ-Bet SLIT. For people aged 5 to 17 years, there are also uncertainties in how the benefits of 12 SQ-Bet SLIT are modelled. But, even when taking these uncertainties into account, the likely cost-effectiveness estimates are all within the range that NICE considers an acceptable use of NHS resources.
So, 12 SQ-Bet SLIT can be used.