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Fighting allergies

Relief under your tongue

May is National Asthma and Allergy Awareness month – not that folks sneezing, sniffling, wheezing and itching their way through it aren't well aware of their allergies by now.

But this year, a bit of relief may await sufferers of some common allergies – a new type of treatment recently approved by the Food and Drug Administration.

Known as sublingual immunotherapy, the treatment fights what's commonly called hay fever.

In April, the FDA approved three new anti-allergy products – Grastek, Oralair and Ragwitek. The products are tablets that can be slipped under the tongue, where they quickly dissolve without water.

The first two are effective against allergies to common grasses, including timothy, Kentucky blue grass, perennial rye, orchard grass, sweet vernal grass and possibly others. Ragwitek works against ragweed pollen.

Dr. Jay Slater, director of the FDA's Division of Bacterial, Parasitic and Allergenic Products, says the three work differently from existing over-the-counter and prescription antihistamines.

“These (new) medications have the potential for dialing down the immune response to allergens, doing more than just treating the symptoms of allergies,” Slater says.

The method of action, the FDA official says, is similar to that of allergy shots, which desensitize the body to the offending substance by exposing it to minute amounts injected under the skin.

Dr. Douglas Neeld, an allergist and immunologist with Lutheran Medical Group, says the new sublinguals, taken once a day during pollen season, could help millions of people.

At least one in five people suffers from grass and ragweed allergies, he says. “Most of these people don't come to an allergist, and an even smaller percentage ever get allergy shots,” he says.

But, as with any medicine, potential drawbacks exist.

Ragwitek is not approved for anyone younger than 18 or older than 65. Oralair can treat children older than 10 and Grastek treats children older than 5, but neither is recommended for seniors.

Dr. William Smits, allergist with The Asthma and Allergy Center in Fort Wayne, says relief isn't immediate.

“The idea is that you have to start (treatment) several months in advance,” he says.

For Oralair, it's four months before the grass pollen season and 12 weeks for Grastek and Ragwitek, according to the FDA. That means it's too late this year for people allergic to grasses, Smits says.

But ragweed sufferers can still benefit, if they act quickly, because that season doesn't start until late summer, he says.

People who used the medicines in studies had a 16 percent to 30 percent reduction in symptoms and need for medication, according to the FDA.

Potential users should first undergo a skin or blood test to make sure they're allergic to ragweed or grasses and not something else, doctors say. Patients also should expect to take the first dose in the doctor's office, so they can be observed for adverse reactions.

The most common side effects are itching or irritation of the mouth, tongue, ears or throat, according to the FDA. But life-threatening swelling of the mouth and throat can occur, although such reactions are rare.

Neeld says patients are trained on, and sent home with, an injectible epinephrine device, such as an EpiPen, as a precaution.

Smits says patients with insurance can expect to spend $20 to $50 a month during pollen season for sublinguals.

He expects more to be approved. “Immunotherapy, it's just an amazing development,” he says.

rsalter@jg.net

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