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Allergy drops instead of allergy shots?

JOHNS HOPKINS (US) — Liquid drops with small amounts of purified grasses, ragweed, dust mites, pollen, or mold can be a safe and effective alternative to weekly allergy shots.

Some allergy and allergic asthma patients may prefer the drops, which are placed under the tongue, because of their convenience. Patients can take them at home, which averts regular time-consuming trips to a doctor’s office.

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“Our findings are clear evidence that sublingual immunotherapy in the form of allergy drops is an effective potential treatment option for millions of Americans suffering from allergic asthma and allergic rhinoconjunctivitis,” says senior investigator Sandra Lin, an associate professor of otolaryngology–head and neck surgery at the Johns Hopkins University School of Medicine.

Lin says that, according to current estimates, as many as 40 percent of Americans suffer from some form of allergic rhinitis or allergic asthma. Immunotherapy—whether shots or oral drops—is for patients who don’t respond well to allergy medicines.

It involves exposing the patient to tiny quantities of whatever provokes an allergic reaction, allowing the body gradually to become accustomed to that allergen.

Lin and colleagues reviewed 63 published studies and report their results in the Journal of the American Medical Association. The research they reviewed involved 5,131 patients, almost all in Europe, where allergy drops have been widely available for nearly two decades.

Sublingual, or under the tongue, allergy therapies have not been approved for use by the US Food and Drug Administration, but physicians in the United States do use the drops “off-label” for some patients.

In eight of 13 allergic asthma studies evaluated, researchers found what they say is “strong evidence” that drop therapy produced a 40 percent or greater reduction in coughing, wheezing, and tightness in the chest compared with other treatments, including inhaled steroids.

In nine of 36 studies comparing allergy drops to other allergy treatments, including antihistamines and nasal steroid sprays, researchers found that allergy drops produced a 40 percent or greater reduction in symptoms of runny nose, sneezing, and nasal congestion, results they describe as “moderate evidence” in support of using sublingual immunotherapy.

Lin cautions that drop therapies may not be for all sufferers of allergic rhinoconjunctivitis and allergic asthma, but that many will want to weigh the risks and benefits of sublingual immunotherapy before deciding on long-term treatment options.

Funding for the study came from the US Agency for Healthcare Research and Quality.

Source: Johns Hopkins University

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