Tuesday, December 28, 2010

Allergies: The Time to Start Treating Is Now

From Allergies Update, at Maloney Medical (all abstracts available there):

Deep winter is the perfect time to start treating for allergies in the spring.  We have a range of different plans that will down regulate the histamine response, but don't wait to start sneezing.  That's like waiting for a flat tire before you go out and get a spare. 

Currently the standard program to desensitize patients involves injections. But the state of the art is now drops under the tongue. “Sublingual immunotherapy (SLIT) has been proved to be effective in allergic rhinitis and asthma…New sensitizations appeared in 34.8% of controls and in 3.1% of SLIT patients.  ” But, you ask, is it as effective as the injections? “The mean peak expiratory flow result (how much air you can exhale) was significantly higher in the active group than in the control group after 10 years.

But can I go off my inhaler? Unfortunately, we don’t know, because: “when mild-moderate asthmatic children are optimally controlled by pharmacologic treatment and HDM (human dust mite) avoidance, SLIT does not provide additional benefit, despite a significant reduction in allergic response to HDM. Under such conditions, only a complete, but ethically unfeasible, discontinuation of inhaled corticosteroid would have demonstrated a possible benefit of SLIT.”  It could be dangerous to remove the inhalers, so we’ll keep people on them for life. Of course, the long term effects of steroids…

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