Antihistamines and nasal steroids offer good short-term options for people with mild allergy, but allergy immunotherapy, better known as "allergy shots," is a preferred method for achieving long term remission of more bothersome allergy symptoms. Allergists mark the 100th anniversary of immunotherapy and present the latest advances at the American College of Allergy, Asthma and Immunology (ACAAI) annual scientific meeting in Phoenix, Nov. 11-16.
"The common question from patients, 'Do I really have to take all these drugs?' has stirred renewed interest in allergy immunotherapy as a preferred method to produce long term remission," said allergist Bobby Lanier, MD, ACAAI executive medical director.
"It is the only allergy treatment that has been shown to prevent the progression of allergic disease, reduce the risk of developing asthma, and provide long term remission after therapy ends," said Dr. Lanier. "Studies demonstrate it reduces the need for medication, as well as use and cost of health care services. And unlike medications, allergen immunotherapy has a long track record of safety in children, the elderly and pregnant women."
Beginning with the first published study on inoculation against grass pollen in 1911, allergy immunotherapy has been proven over the past century as a safe, effective treatment against allergens including pollen, mold, insects and animals, and also for allergic asthma. The treatment stops the source of the patient's suffering rather than just treating the symptoms.
The immunization procedure begins with injections of small amounts of purified "extracts" of the substances that cause the allergic reaction. They are approved for this use by the Food and Drug Administration (FDA).
What's next in immunotherapy?
Alternative methods of administration offer promising new treatments on the horizon including sublingual immunotherapy (SLIT), the absorption of the allergens into the body by keeping drops or tablets in the mouth under the tongue. Instead of an injection, the allergens are absorbed through the tissues in the mouth. SLIT can be self-administered in the home and is accepted in some European and Latin countries. It is not approved by the FDA for use in the U.S., and is considered investigational.
"Although SLIT is more convenient than traditional immunotherapy and appears to be safe, there are several major impediments to its approval for use in the U.S.," said allergist Ira Finegold, MD, ACAAI Fellow and member of the Immunotherapy and Diagnostics Committee "These include unresolved issues of standardized dosing, frequency and duration."
The majority of allergic U.S. patients are sensitive to more than one allergen. SLIT studies have not demonstrated efficacy in allergic patients with multiple sensitivities - whereas traditional immunotherapy is effective in treating these patients.
"An allergist can help evaluate what treatments are right for you and help you find relief," Dr. Finegold said.
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