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: Until now, I have only posted articles about a specific brand of a medication if it is the only one available in its class. However, the absence of Auvi-Q has been a real problem from many patients, especially because the manufacturers of its competitor (EpiPen by Mylan) raised its price prohibitively high. Continue reading “AUVI-Q RETURNING TO MARKET IN 2017”
FCAAIA Notes: I have written about the upper-lower airway connection in this blog many times. Most young people with asthma have allergies and 20-60% of those with allergies will develop asthma. The two conditions can be thought of as the same disease affecting different ends of the respiratory system or “allergic airway disease”.
There is a large literature supporting the fact that treating the upper airway (nose) can lead to improved control of the lower airway (asthma). In fact, the most recent iteration of national guidelines for the care of asthma tell us that anyone with persistent asthma (defined in part as symptoms >2 days per week or night time symptoms > 2 nights per month) and allergies should consider allergy shots as a potential cure for his allergic airway disease. Continue reading “IMMUNOTHERAPY IN ALLERGIC RHINITIS AND LOWER AIRWAY OUTCOMES”
FCAAIA Notes: For all intents and purposes, one can usually consider allergic rhinitis and asthma as the same disease affecting different ends of the same airway. I frequently refer to the combination as “allergic airway disease”. The conditions have the same underlying pathophysiology, immunology, triggers, and tenets of treatment. We know that the vast majority of young people with asthma have allergies. We have also long recognized the “atopic march” or “allergic march”, in which patients progress from atopic dermatitis, to allergic rhinitis, to asthma. Continue reading “STUDY INVESTIGATES THE EFFECTIVENESS OF ALLERGY IMMUNOTHERAPY TO PREVENT ASTHMA IN ALLERGIC RHINITIS”