An estimated 50 million people in the United States are affected by allergies. That’s as many as 30 percent of adults and 40 percent of children. Allergic diseases, including asthma, are the fifth-most-common chronic diseases among adults. Sufferers learn quickly there is no cure for allergies. As they explore treatment, inevitably they ask, “What is allergen immunotherapy?”
Allergic reactions start in the same immune system that protects the body from invading organisms that can cause illness. In the allergy sufferer, the immune system overreacts and produces antibodies that release histamine and other chemicals. This causes the allergic reaction. Immunotherapy works like vaccine, introducing allergens slowly in a way that allows the body to develop a tolerance to them.
‘Allergy shots have shown to decrease symptoms’
Subcutaneous immunotherapy – allergy shots – is the most widely used immunotherapy treatment in the United States. Prescriptions are prepared based on patients’ specific allergy testing results. Injections are administered in the physician’s office and are covered by most insurance plans. Patients usually begin with a low dose/low concentration of allergy extract and build up to their maintenance dose over a period of months. Patients then continue with injections on a weekly or biweekly schedule.
According to the American Academy of Allergy Asthma & Immunology, “Allergy shots have been shown to decrease symptoms of many allergies. It can prevent the development of new allergies, and in children it can prevent the progression of allergic disease from allergic rhinitis to asthma. The effectiveness of allergy shots appears to be related to the length of the treatment program as well as the dose of the allergen. Some people experience lasting relief from allergy symptoms, while others may relapse after discontinuing allergy shots. If you have not seen improvement after a year of maintenance therapy, your allergist / immunologist will work with you to discuss treatment options.”
‘A safe and effective alternative to weekly injections’
Sublingual immunotherapy – allergy drops – is an alternative to injections for patients suffering from a wide range of allergies. A team from Johns Hopkins University conducting a scientific review of 63 published studies on allergy drops called them “a safe and effective alternative to weekly injections.”
Senior study investigator Sandra Lin, M.D., said, “Our findings are clear evidence that sublingual immunotherapy in the form of allergy drops are an effective potential treatment option for millions of Americans suffering from allergic asthma and allergic rhinoconjunctivitis.”
Allergy drops are not new. They have been used in Europe for almost 30 years and today account for more than half of the immunotherapy done there. The antigens used in drops are the same ones used in injections. These antigens have been approved by the FDA for use in the U.S. for decades. Their use in drops has not yet been given final approval by the FDA, which for now still views allergy drop prescription an off-label use. Off-label use of medications is common in medicine. The best-known example may be aspirin prescribed to patients with heart conditions.
After allergy testing, an individualized extract prescription is prepared for each patient based on their specific allergy testing results. Patients can reach their maintenance dose in a month. Unlike injections, allergy drops can be self-administered at home.
Allergy drops are not covered by insurance plans or Medicare. However, some patients may be able to use health savings accounts or flexible spending accounts to help cover the cost. And compared to injections, allergy drops can be the more economical choice.
Dr. Jeffrey S. Hallett, M.D., is the first, — and most experienced — fellowship-trained and board-certified allergist in the Austin area to offer allergy drops. Dr. Hallett has offered the more effective high-dose, European Protocol allergy drops as an option for his immunotherapy patients since 2009.
“If it’s dosed appropriately, the oral treatment is just as effective as the injections,” Dr. Hallett says. “They’re prepared a little differently, but it is exactly the same product that we use for both forms of treatment.”