FCAAIA Notes: Allergen immunotherapy (IT) is the only disease-modifying treatment and thus the only potential cure for allergies. People respond at different rates to different extents, but it is a highly effective treatment.
For IT to be helpful, you need to come regularly to build up to the top dose. High doses are more effective than lower doses. Continue reading “IS RESPONSE TO ALLERGY IMMUNOTHERAPY PREDICTABLE?”
FCAAIA Notes: The four broad categories of treatment for allergic rhinitis are avoidance of triggers, symptom reliever (rescue) medications, controller (preventive) medications, and allergen immunotherapy. Only immunotherapy can “cure” the disease by changing the way your immune system recognizes and responds to the triggers of your nasal allergies.
Immunotherapy can be administered by injections (subcutaneous, “SCIT”) or under the tongue (sublingual “SLIT”). Although many practitioners offer SLIT for all allergens as drops, SLIT is only available and FDA approved for grass and ragweed. Dust mite SLIT has been approved but is not commercially available yet.
Although there are not many well-controlled studies, SCIT is more effective than SLIT for pollen immunotherapy and Continue reading “ALLERGEN IMMUNOTHERAPY: AN UPDATED REVIEW OF SAFETY”
FCAAIA Notes: I have posted many articles on the safety and efficacy of allergy shots. This report confirms that allergy shots are a very safe treatment. However, it also addresses the risk of systemic allergic reactions to sublingual (under the tongue, SLIT) tablets and drops. It is now clear that those treatments also carry risk of severe allergic reactions. There are not large numbers of patients treated and reports yet because of the relative newness of SLIT tablets but by just doing the arithmetic, it is not clear to me that SLIT is all that much safer than subcutaneous immunotherapy (SCIT). Furthermore anyone who has an allergic reaction to SLIT does so at home, not in a medical office, thereby increasing the risk of a bad outcome. All patients on SLIT should have an epinephrine auto-injector at home. Continue reading “SYSTEMIC REACTIONS UNCOMMON WITH SCIT”
FCAAIA Notes: Sublingual immunotherapy (SLIT) tablets are already FDA approved for grass and ragweed. Personally, I have not found that they have a great role in the care of patients here in southwestern Connecticut. There are few patients so allergic to only those allergens that they require immunotherapy. If patients are on injections (subcutaneous allergen immunotherapy, SCIT) for multiple allergens, grass and ragweed are included if indicated. The tablets are very expensive and often not covered by insurance.
However, there are more patients allergic only to dust mites who are bad enough that immunotherapy is indicated. SLIT tablets are an alternative for those patients when they reach the market.
A great weakness in the study and marketing of new products is that they are usually not compared to existing products in head-to-head studies. Continue reading “ODACTRA FIRST SUBLINGUAL THERAPY OK’D FOR HOUSE DUST MITE ALLERGY”