Allergen immunotherapy injections, or allergy shots, are prescribed for patients with allergic rhinitis or nasal allergies, commonly known as hay fever, allergic asthma or life-threatening reactions to insect stings. Immunotherapy is a medical treatment that has the potential to modify allergic disease. Studies have shown that it plays a protective role in allergic children, possibly preventing asthma from developing in patients with allergic rhinitis. Immunotherapy is considered for individuals who have moderate or severe symptoms not adequately controlled by allergen avoidance and/or medications. It is also appropriate when you want to avoid chronic medication use, or the medications are not tolerated.
There are generally two phases to immunotherapy: a build-up phase and a maintenance phase.
(SLIT) is an alternative way to treat allergies without injections. An allergist gives a patient small doses of an allergen under the tongue to boost tolerance to the substance and reduce symptoms. Currently, the only forms of SLIT approved by the FDA are tablets for ragweed, northern pasture grasses like timothy, and dust mites. The safety and effectiveness of allergy drops is still being established by the FDA, and they are only used off-label in the United States. Dr. Amy Schiffman can evaluate your symptoms and provide you with the best options.
OIT, or oral desensitization for food allergies, is a medical treatment guided by Dr. Schiffman, during which the immune system is re-trained to tolerate food proteins or allergen through regular eating of small amounts of food. The outcome is protection from accidental exposure to a known food allergen. Some patients can freely consume formerly allergic foods at will. During OIT, the food allergen is administered slowly, in small but steadily increasing doses, until the patient is desensitized.
The first day of treatment is a build-up day, during which multiple doses of very small amounts of allergen are administered. This procedure may take up to 5 hours. The patient continues to eat a “safe dose” at home, once daily. Dose increases occur in the office, every 1-2 weeks, after assessment by the physician. After each dose there is a 1 hour observation period. Instructions on home dose administration, when to avoid dose increases, and treatment of side effects are reviewed at each office visit. The timeline for achieving the target dose depends on each individual patient. If everything goes well, some amount of the allergenic food will be ingested during the 4th – 6th month, and a whole serving of the allergenic food may be ingested by the 8th month. The allergenic food must continue to be consumed on a daily basis to maintain the ability to eat it safely.
Biologic therapy as the name implies, are products derived in some way from living organisms. These treatments include a variety of vaccines, blood components and proteins that are either derived from natural sources or are synthesized in the laboratory. Immune modifying biologic therapies target specific molecules in the body that contribute to an allergic disorder and are particularly relevant to patients with allergic and immunologic diseases. Biologic therapy is available for treatment of severe, allergic and eosinophilic asthma, atopic dermatitis (eczema), and hives.