ARLINGTON HEIGHTS, IL – (APRIL 2, 2019) – Allergy shots (subcutaneous immunotherapy or SCIT) have been available for more than 100 years. Allergy tablets (sublingual immunotherapy or SLIT) have been approved by the Food and Drug Administration (FDA) for use in the United States for four years. A new study in Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI) shows that most American allergists now prescribe the tablets for some patients to treat certain allergies. The study was developed by the ACAAI Immunotherapy and Diagnostics Committee.

“Five years ago, allergy tablets hadn’t been approved by the FDA and weren’t being prescribed for people with allergies in the U.S.,” said allergist Anita Sivam, DO, ACAAI member and lead author. “Allergists were prescribing allergy shots because they were, and continue to be, a proven effective treatment. Once allergy tablets were approved in 2014, allergists began prescribing them for their patients. Of the 268 US allergists who responded to our survey in 2018, 197 (73 percent) reported prescribing allergy tablets.”

Allergy tablets are available to treat northern grass pollens, Timothy grass pollen, ragweed and house dust mite. The northern grass pollens and the Timothy grass pollen tablets are both approved down to age 5 years and the other two for those 18 years and older. The tablets differ from allergy shots because after the first dose is given in an allergist’s office, they can be taken at home. The tablets are placed under the tongue and dissolve.

In immunotherapy, the regular administration of the allergen doses causes your immune system to become less sensitive to the allergen. Reducing your sensitivity reduces your allergy symptoms.

“One of the big differences between shots and tablets is that shots are formulated by your allergist to treat your specific allergy or allergies,” says allergist Mike Tankersley, MD, MBA, vice-chair of the ACAAI Immunotherapy and Diagnostics Committee and co-author of the study. “Tablets target a single allergy, and our study found that was the main barrier for allergists in prescribing tablets. If a patient has more than one allergy and is able to travel regularly to receive allergy shots, an allergist may recommend shots over tablets.”

Both shots and tablets – the only FDA-approved immunotherapy treatments for allergies – are successful because they work by changing your immune system. They decrease some cells, chemicals and antibodies in your system that cause allergy symptoms and increase others that improve health. Allergy shots and tablets allow you to encounter your allergens without having a reaction. Immunotherapy also reduces the inflammation that characterizes hay fever and asthma, so many sufferers find their symptoms improve.

To find an allergist near you who can help create a personal immunotherapy plan for your allergies or asthma and help you lead the life you want to live, use the ACAAI allergist locator.

Citation:  https://acaai.org/news/new-research-shows-73-percent-allergists-prescribe-under-tongue-allergy-tablets?

Park Allergy Center provides both oral drops or tablets for allergy immunotherapy treatment.

 

FDA OKs 1st generic version of popular Advair asthma inhaler

January 30, 2019

The first generic version of the popular Advair asthma inhaler has been approved by U.S. regulators.

The Food and Drug Administration on Wednesday approved Mylan’s version in three strengths for ages 4 and up.

The inhalers are used twice daily to keep airways open and prevent flare-ups of wheezing, shortness of breath and other symptoms of asthma or chronic obstructive pulmonary disease. About 42 million Americans have those conditions.

The device contains two medicines, inhaled in a precise mixture. That complexity has stymied a couple of other companies developing generic versions of GlaxoSmithKline’s Advair Diskus inhaler, which costs about $400 a month.

Generics generally are cheaper. Mylan didn’t immediately respond to queries about when its inhaler, called Wixela Inhub, will be available or what the price will be.

Citation:  https://www.apnews.com/20414480b66e4a06970a92b48a412e01

Citation:  acaai.org/allergies/allergy-symptoms/cough?

Signs of Allergies

Most people have experienced a cough caused by a cold or flu — the kind of cough that comes on strong for a few days during an illness, and then tapers off as you start to feel better. But what if you have a cough that just won’t go away?

GET RELIEF

Find an allergist

If you have a chronic dry cough (a cough that has lasted for more than three weeks), it may be a symptom of allergies or asthma.

If your cough is allergy-related, you might notice that you cough more during some seasons, or in some environments. This can be caused by the presence of allergens that may affect you.

You might also have other symptoms of allergy. Hay fever (allergic rhinitis) can cause sneezing, congestion, and itchy skin, eyes and nose, as well as a cough. Congestion from allergies can also cause dark circles, called allergic shiners, to appear under your eyes.

An allergy cough is caused by your immune system’s response to an allergen, rather than by an infection like a flu or cold cough. Asthma can also cause a cough. If you are also wheezing or have tightness in your chest or shortness of breath, you may have an asthma cough. Your board-certified allergist is a specialist in helping patients find relief from symptoms like asthma and allergy cough.

Triggers

Asthma and allergy coughs are typically caused by swelling or irritation of the airways.

Allergies like hay fever can cause a chronic dry cough. If you’re sensitive to dust, pet dander, pollen, mold, or other common allergens, then your allergy symptoms may include a cough. Allergies can also worsen your asthma symptoms, causing them to become severe.

Learn about some common allergy triggers and how to avoid them:

How to Get Tested

If you’re suffering from a chronic cough that might be related to allergy or asthma, it’s important to get tested. Your board-certified allergist will review your symptoms, take your detailed medical history and conduct testing to complete a diagnosis. This process helps identify the specific triggers that affect you, so you can get relief.

Skin testing is the most commonly used form of allergy testing, and it is fast and accurate. In certain circumstances, your allergist may conduct blood testing in addition to or instead of skin testing. You may also take a breathing test, which can help in diagnosing asthma.

Your test results, along with your medical history, will give your allergist the information needed to develop a treatment plan and help you find relief!

It Could Also Be…

Ninety percent of chronic coughs are related to one of the following:

  • Asthma
  • Chronic bronchitis
  • Gastroesophageal reflux (GERD)
  • Postnasal drip
  • Smoking

If your allergist rules out allergies, asthma and the conditions listed above, ask what else might be causing your chronic cough, such as:

  • Blood pressure medications
  • Bronchiectasis
  • Cystic fibrosis
  • Infection (viral or bacterial)
  • Laryngopharyngeal reflux
  • Lung cancer
  • Sarcoidosis

https://acaai.org/allergies/allergy-symptoms/cough?fbclid=IwAR3oTDUeLyYoqewDJahhu9XKqfu1aW9OPZCUGQJcFUOZeQd3a4jUDpoZexU

https://www.medscape.com/viewarticle/906135

Megan Brooks

December 2018

More than 40% of Americans have not been vaccinated against influenza this year and don’t plan to get vaccinated, despite repeated warnings about the potential dangers of the flu, as well as last year’s record-high number of deaths from flu, a new survey indicates.

The survey included 1202 interviews with a nationally representative sample of adults aged 18 years and older. It was conducted between November 14 and 19 by the National Opinion Research Center (NORC) at the University of Chicago.

Results showed that 43% of adults had received the flu shot and that 14% had not yet been vaccinated but intended to get vaccinated this season. Yet, 41% of adults surveyed said they had not been vaccinated and did not intend to get vaccinated. About 2% were undecided about getting the flu shot or did not respond to the question.

The highest vaccination rate (62%) was for adults older than 60 years, a group at higher risk for flu-related complications. However, 1 in 4 (24%) people aged 60 years and older did not plan to get vaccinated this year.

Adults younger than 45 were the least likely to report being vaccinated. Roughly half of this group indicated that they did not plan to receive a vaccination this year.

Among adults who have children younger than 18 years living in their home, 39% said they do not vaccinate their children.

Misconceptions Common

The top reasons people cited for not getting vaccinated against the flu were concern about side effects from the vaccine (36%), concern about getting the flu from the vaccine (31%), and because they never get the flu or they do not think the flu vaccine works (31%).

“Unfortunately, many people are still not getting flu shots due to broader misconceptions about the value of receiving a flu shot and concerns about the safety and efficacy of the vaccines,” Caitlin Oppenheimer, MPH, senior vice president of public health research at NORC, said in a news release.

The Centers for Disease Control and Prevention (CDC) recommends routine annual influenza vaccination for all persons aged 6 months or older who do not have contraindications. The CDC estimates that flu vaccination coverage among adults was 37% for the 2017-2018 season and 43% for the 2016-2017 season.

Last year’s flu season was particularly severe, with a record-breaking 900,000 hospitalizations and more than 80,000 deaths in the United States. Although most flu deaths were in adults older than 65, the flu also killed 180 children and teenagers.

Many survey respondents did not know this. About two thirds (63%) incorrectly believed that last year’s season was about the same as usual, was less severe than usual, or they did not know. People who had already received their flu shot for this season were more aware of the severity of last year’s flu season; 43% of people who had already been vaccinated correctly identified last year’s season as being more severe than usual, compared to only 30% of people who do not plan to get vaccinated.

“Flu vaccination helps prevent people from getting sick with the flu and reduces the severity of illness for those who do get sick. Widespread vaccination also helps create ‘herd immunity’ that protects vulnerable groups who are prevented from getting vaccinated,” Caroline Pearson, BA, senior fellow at NORC, said in news release. “Unfortunately, over half of all adults are currently unvaccinated, with four in 10 not intending to get vaccinated, placing themselves and those around them at risk.”

Things you need to know about the flu.  https://acaai.org/asthma/conditions/flu

Overview

Unlike other viral respiratory infections, such as the common cold, the flu can cause severe illness and life-threatening complications. In 2010 the Centers for Disease Control and Prevention reported that from 1976 to 2007, between 3,000 and 49,000 people died annually from flu-related complications, with the variation in the death toll related to the specific flu strain circulating in a particular year. The risk is greater for very young children, people age 65 and older and people with chronic medical conditions, such as asthma.

Because both asthma and the flu are respiratory conditions, people with asthma may experience more frequent and severe asthma attacks if they get the flu. As a result, it is particularly important for people with asthma to take steps to minimize their risk of exposure.

Symptoms
  • Fever
  • Headache
  • Fatigue
  • Dry cough
  • Sore throat
  • Nasal congestion
  • Body aches
Management and Treatment

How does the flu spread?

Influenza is a contagious disease that attacks the respiratory tract, including the nose, throat and lungs. The flu spreads when an infected person coughs or sneezes, spraying droplets into the air and onto people nearby. It can also be spread by touching droplets on another person or object and then touching your own mouth or nose before washing your hands. Infected people are contagious one day before developing symptoms and up to seven days after getting sick.

How can you tell if you have the flu?

Because many flu symptoms are similar to those of other respiratory infections, including the common cold, the only way to be sure it’s the flu is to see your doctor. There are tests that can determine if you have the flu as long as you are tested within the first two or three days after your symptoms begin. In general, if your respiratory symptoms are accompanied by sudden onset of body aches and fever and occur during flu season, suspect the flu.

When is flu season?

Peak flu season months in the U.S. are December, January and February; flu season can last from November through March. Fortunately for people living in most parts of the U.S., flu season doesn’t correspond to periods of peak pollen counts, which can trigger and aggravate asthma in those who are allergic.

How can you prevent the flu?

The best way to prevent the flu is to get vaccinated each fall. This is particularly important for those who have chronic respiratory conditions, such as asthma. The vaccine triggers the development of antibodies that fight the flu virus when the body is exposed to it. There are two types of flu vaccines: injection (the flu shot) and nasal spray.

Those who have asthma or other chronic medical conditions should get the flu shot, which is an inactivated vaccine (meaning that it contains killed virus). The best time to get it is in October or November, as it typically takes about two weeks for sufficient antibodies to develop.

The flu shot is approved for use in very young children, including those with chronic medical conditions, such as asthma.

Allergists urge everyone who has asthma to get the flu vaccination as part of his or her routine care. Flu viruses change from year to year, so being vaccinated one year will not necessarily protect you from different flu viruses in subsequent years.

The second type of flu vaccine, administered through a nasal spray, contains attenuated (weakened) live viruses. It is approved for use only by healthy people ages 5 to 49. Because it contains live viruses, the nasal-spray flu vaccine should not be used in people with asthma, as it can provoke or aggravate symptoms.

Most varieties of the flu vaccine contain small amounts of egg protein. An updated guideline from the Joint Task Force on Practice Parameters stresses that no special precautions are needed or recommended for those with egg allergy when it comes to the flu vaccine. There is no longer a need to:

  • See an allergy specialist for the flu shot.
  • Give special flu shots that don’t contain traces of egg.
  • Require longer-than-normal observation periods after the shot, or
  • Even ask about egg allergy before giving the vaccine.

If the vaccine is age-appropriate, it can be used for anyone with or without egg allergy.

What should you do if you get the flu?

The best strategy for recovering from the flu is to rest, drink plenty of fluids and avoid using alcohol and tobacco. Over-the-counter medications can relieve the symptoms of the flu, but never give aspirin to children or teenagers who have symptoms of the flu — particularly fever — without consulting a doctor first. Aspirin use in children and teenagers with flu-like symptoms has been linked to Reye’s syndrome, a serious condition that causes swelling in the liver and brain.

Your doctor also may prescribe an antiviral medication, such as Tamiflu (oseltamivir phosphate) or Relenza (zanamivir), to treat the flu, but these are effective only if started within the first two days of experiencing symptoms.

Citation:  acaai.org/asthma/conditions

Based on our research, this is the latest summary of currently available versions of injectable epinephrine in the United States as of December 2018.

Auvi-Q (Kaleo) $700

EpiPen (Mylan) $600

generic EpiPen (Mylan) $300

generic EpiPen (Teva) $300

generic Adrenaclick (Impax) $110

Prices reflect the LIST PRICE for a 2-pack and do not include coupons or other special discounts.

Christmas Trees and Allergies – https://acaai.org/allergies/types-allergies/pine-tree-allergy

“While pine tree allergy is relatively uncommon, there are two main allergens of concern that come from pine trees: pine nuts and pine pollen. Pine nuts (pignoli) are the edible seeds of certain species of pine trees, and are used in a variety of foods, including Italian pesto. Pine nut consumption has increased due to its use in the Mediterranean Diet. Pine pollen is produced when the trees reproduce in the springtime. It is possible for pollen to travel very long distances in the air.” — ACAAI News https://acaai.org/news/

Symptoms

Symptoms of pine pollen allergies are much like “hay fever” and typically include:

  • Itchy tearing red eyes
  • Bags under the eyes
  • Runny nose with or without sneezing and congestion
  • Coughing

In some cases pollen may aggravate asthma.

Pine nut allergies are much like other tree nut allergies in that they can cause anaphylactic reactions. Symptoms may vary from mild to severe and include:

  • Tightness in the chest and difficulty breathing
  • Swelling of the tongue, throat, nose and lips
  • Hives or rash
  • Abdominal pain, diarrhoea, and/or vomiting
  • Dizziness and fainting or loss of consciousness
  • Shock and heart failure

If you have an anaphylactic reaction, even if it is mild, consult your allergist as these symptoms won’t go away. Symptoms include those listed above and:

  • Itchy throat
  • Sneezing
  • Abdominal discomfort

Citation: ACAAI News https://acaai.org/news/

Allergy injections and eczema – https://acaai.org/news/your-severe-eczema-may-best-be-treated-allergy-shots

“SEATTLE (November 16, 2018) – If you’ve suffered with severe atopic dermatitis (eczema) for a long time and have tried what you think is every available option for relief, you may want to consider allergy shots. A medically-challenging case being presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting found that allergy shots provided significant benefits to the eczema symptoms suffered by a 48-year-old man.” — ACAAI News https://acaai.org/news/