Allergy Alert—Making Allergy Season Easier to Swallow

June 2014 View more

iStock_000014042429LargeAllergy season is in full swing. And if you suffer from allergies, you’re not alone. In fact, one in five Americans has allergies with many of those allergy sufferers taking regular trips to the doctor for allergy shots. But there could soon be a major change in the way serious allergies are treated. Imagine skipping the trip to the doctor’s office for a shot, and instead, simply dissolving a pill under your tongue. “I think it is great to have another option for immunotherapy for our patients. There are so many situations where patients may not be able to get allergy shots and this could be an option for them,” said Dr. Laura Rogers, of Laura Rogers Allergy and Asthma in Chicago.

Allergy Relief

The Food and Drug Administration is considering treatments that do the same thing as injections, but in tablet form. Oralair, produced by a French company called Stallergenes, has been given the green light by the FDA to be used to reduce hey fever symptoms. Now, doctors can offer it to patients between ages 10 – 65. Patients start taking the tablet on a daily basis four months before grass pollen season begins. Oralair contains freeze-dried extracts from pollens of the five most common grass types in the United States. The grass types include Timothy, Kentucky bluegrass, perennial rye, sweet vernal, and orchard. “I am excited for this treatment to become available to patients as it has been in Europe for many years. We have been anticipating approval by the FDA for quite some time now. This type of treatment is a way to drastically control your allergies, although it is not as dramatic as allergy shots, and both treatments take time,” said Dr. Rogers.

Possible Side Effects

Other tablets are currently waiting FDA approval including two experimental immunotherapy tablets created by the New Jersey drug maker Merck, one for grass pollen allergies and one for ragweed. Merck plans to call the grass product Grastek. It contains extract from Timothy grass. This tablet would be taken every day for 12 weeks before the start of grass pollen season. Then during the six to eight weeks of the grass pollen season, it retrains the immune system to not react so strongly. The tablet is kept under the patient’s tongue for about one minute until it completely dissolves. “About 30 percent of people who put this tablet under their tongue will experience itching, maybe some minor swelling,” said Dr. David Skoner, chief of allergy, asthma and immunology at Allegheny Health Network in Pittsburgh. He is also a consultant to Merck. In some rare cases, the swelling is severe and there can be shortness of breath and a drop in blood pressure. For those reasons, the first dose must be taken in the doctor’s office.

The labeling will also include a strong recommendation to have emergency Epinephrine on hand at home. “A few people might have used Epinephrine in the trials, but it was never really certain they needed it, or that it was caused by the tablet,” said Dr. Skoner. An FDA advisory panel has recommended its approval.

The proposed trade name for Merck’s ragweed allergy immunotherapy tablet is Ragwitek. This tablet is also currently in front of the FDA for approval. “The need for something like this in the consumer market is high. You can do this therapy at home every day,” said Dr. Skoner.

Tablets vs. Pills

Researchers say the tablets work better than antihistamine pills, which only treat the allergy symptoms. However, some allergists are opposed to using the pills, because it could change the demand for allergy shots and keep some patients out of the doctor’s office for important overall health monitoring and evaluation.