The treatment, which is known as sublingual immunotherapy, is based on the same principles as traditional allergy shots but is different as it is about administration via drops or tablets that dissolve under the tongue.

From in.reuters.com:

In an email, Di Lorenzo told Reuters Health that the findings suggest that sublingual immunotherapy is “highly effective in many, but not in all patients.” He said that more work is needed to identify which patients might be most likely to benefit.

Dr. Harold Nelson, an allergist at National Jewish Health in Denver, said that the body of evidence indicates that sublingual immunotherapy beats antihistamines and other medications used to control hay fever symptoms.

In an interview, he noted that antihistamines reduce symptoms by about 12 percent to 15 percent, on average. Nasal steroids, another hay fever option, appear to cut symptoms by about 17 percent.

On the other hand, Nelson said, allergy shots appear to outperform the oral versions, with a symptom reduction about twice that of sublingual immunotherapy.

In addition, the long-term effectiveness of the grass-pollen tablets is not yet fully clear.

The benefits were termed as “modest” by the researchers who were led by Dr. Gabriele Di Lorenzo of the University of Palermo.

Corticosteroid nasal sprays

The finding, which was published in the November 26 issue of the Archives of Internal Medicine, suggested that the current prescription patterns and guidelines flavoring the use of antihistamines to be the first-line treatment option for mild or moderate allergies need to be altered.

From Sciencedaily.com:

Antihistamines can block the actions of histamines if taken in advance but they have no impact on the late response. Intranasal steroids inhibit the late response and prevent priming.

“Antihistamines,” explained Naclerio, “taken once symptoms have already appeared, arrive too late to block the early response and have little effect on the late response. Corticosteroids taken when symptoms begin can prevent the late response and inhibit priming, which makes the patient more sensitive to subsequent contacts.”

“Our study,” he added, “demonstrates the greater importance of the late response compared to the immediate response.”

The authors emphasize that continuous medication use is more effective than sporadic use in response to symptoms but acknowledge that few patients comply with those instructions.

In light of their findings, they suggest revising the current guidelines so that “intranasal corticosteroids should become the first-line treatment for seasonal allergies. They should now be recommended for regular use in patients with severe disease,” said Naclerio, “and for as-needed use in patients with mild disease.”

Robert Naclerio, M.D., chief of otolaryngology-head and neck surgery at the University of Chicago and director of the study, remarked more people will be benefiting and health costs can be dramatically reduced by altering the present guidelines to match patient practice.

It was remarked by doctors from Thomas Jefferson University Hospital that after the symptoms have been alleviated, patients can remain on the drug.

From News-Medical.Net:

“This is a very important study for many cardiac patients but especially those with stents,” said Savage. “Every patient who receives a stent must take Plavix to help prevent stent thrombosis which is clotting of the stent. This obviously poses major problems if the patient suffers an allergic reaction to the medication. To discontinue taking the drug can lead to a heart attack which may be fatal. Those with a drug eluting stent are required to be on the drug for at least one year. Our patients with drug eluting stents actually averaged 17 months on Plavix versus the minimum of one year. That’s a very long time to not be on a medication that may save your life.”

Plavix is one of the most prescribed drugs world-wide. Data from 2007 shows Plavix is the fourth most sold drug in the United States with almost four billion dollars in sales, according to IMS Health, a leading pharmaceutical industry monitoring company. It is estimated that about six percent of those taking the drug showed some signs of an allergic reaction.

John R. Cohn, M.D., chief of Adult Allergy at Thomas Jefferson University and Hospitals and a key contributor to the study noted, “Previously, when patients had an allergic reaction to Plavix we would give an alternative drug but they can have their own side effects. Rather than giving the secondary drug we concentrated on suppressing the patient’s allergic symptoms they were having to Plavix by administering low doses of steroids and antihistamines while continuing the drug. What we found was that most of our patients became tolerant to Plavix, essentially becoming ‘desensitized’ to the drug enabling them to continue treatment. Once this occurred we were able to discontinue the steroids and even the antihistamines.”

The study findings were presented at the American College of Cardiology’s Annual Scientific Session by Primary investigator Michael P. Savage, M.D., director, Cardiac Catheterization Laboratory at Thomas Jefferson University Hospital and Kimberly L. Campbell, M.D.

Plavix is one of the world’s most widely-used and prescribed drugs also known by the name clopidogrel.

The findings were presented at the American College of Cardiology’s Annual Scientific Session on March 30, 2009 by primary Investigator Michael P. Savage, M.D., director, Cardiac Catheterization Laboratory at Thomas Jefferson University Hospital and Kimberly L. Campbell, M.D., cardiology fellow and lead author.

From Sciencedaily.com:

John R. Cohn, M.D., chief of Adult Allergy at Thomas Jefferson University and Hospitals and a key contributor to the study noted, “Previously, when patients had an allergic reaction to Plavix we would give an alternative drug but they can have their own side effects. Rather than giving the secondary drug we concentrated on suppressing the patient’s allergic symptoms they were having to Plavix by administering low doses of steroids and antihistamines while continuing the drug. What we found was that most of our patients became tolerant to Plavix, essentially becoming ‘desensitized’ to the drug enabling them to continue treatment. Once this occurred we were able to discontinue the steroids and even the antihistamines.”

It is noteworthy to remember that anecdotal studies in the past have clearly suggested that some patients may be desensitized to Plavix but this is the first study to demonstrate drug allergy is easily manageable without discontinuing the drug usage after a reaction has been experienced.

Doctors from the Thomas Jefferson University Hospital said that after the symptoms have been minimized, patients can remain on the drug. The findings of this study were presented at the American College of Cardiology’s Annual Scientific Session by Primary investigator Michael P. Savage, M.D., director, Cardiac Catheterization Laboratory at Thomas Jefferson University Hospital and Kimberly L. Campbell, M.D.

From News-Medical.Net:

“This is a very important study for many cardiac patients but especially those with stents,” said Savage. “Every patient who receives a stent must take Plavix to help prevent stent thrombosis which is clotting of the stent. This obviously poses major problems if the patient suffers an allergic reaction to the medication. To discontinue taking the drug can lead to a heart attack which may be fatal. Those with a drug eluting stent are required to be on the drug for at least one year. Our patients with drug eluting stents actually averaged 17 months on Plavix versus the minimum of one year. That’s a very long time to not be on a medication that may save your life.”

Plavix is one of the most prescribed drugs world-wide. Data from 2007 shows Plavix is the fourth most sold drug in the United States with almost four billion dollars in sales, according to IMS Health, a leading pharmaceutical industry monitoring company. It is estimated that about six percent of those taking the drug showed some signs of an allergic reaction.

John R. Cohn, M.D., chief of Adult Allergy at Thomas Jefferson University and Hospitals and a key contributor to the study noted, “Previously, when patients had an allergic reaction to Plavix we would give an alternative drug but they can have their own side effects. Rather than giving the secondary drug we concentrated on suppressing the patient’s allergic symptoms they were having to Plavix by administering low doses of steroids and antihistamines while continuing the drug. What we found was that most of our patients became tolerant to Plavix, essentially becoming ‘desensitized’ to the drug enabling them to continue treatment. Once this occurred we were able to discontinue the steroids and even the antihistamines.”

It is considered by many researchers that Plavix allergy can be efficaciously managed without discontinuing the usage after a reaction has been experienced by the Plavix user. It is believed that these findings would help medical practitioners for treating allergic reactions to other life-saving drugs.