Tablets Help Relieve Symptoms Such as Runny Nose, Congestion, Watery Eyes
By Charlene Laino
WebMD Health News
Reviewed by Louise Chang, MD
March 5, 2012 (Orlando, Fla.) -- For many allergy sufferers, getting shots is a pesky, even painful part of ragweed season. Now, researchers report success testing an under-the-tongue tablet as an alternative to injections in people with ragweed allergies.
In a study of more than 500 people with ragweed allergies, people who took the experimental tablets had less nasal congestion, eye tearing, and other allergy symptoms than those who took a placebo. Those given the new pills also needed fewer antihistamines and other allergy medications for relief.
The treatment is a type of immune therapy, the most common form of which is the allergy shot. Tiny amounts of the proteins to which you are allergic are injected to weaken the immune system's response to ragweed, grass, or other allergy triggers.
The new treatment works much the same way, but instead you put a tablet containing tiny extracts of allergens -- in this case ragweed proteins -- under the tongue each day until tolerance develops.
Immune therapy is the only treatment that's been proven to modify the natural course of the allergic disease, "actually turning it off and keeping it suppressed over time," says Johns Hopkins' Peter Creticos, MD, who led the new study.
Shots may work, "but some people are afraid of the needle or don't have time to go to the doctor's office [two to four times a month] during allergy season to get them," he says.
Also, "3% to 6% of people on allergy shots have systemic [throughout the body] allergic reactions that can be severe or life-threatening," Creticos tells WebMD.
That makes the tablets a welcome option, he says.
Merck & Co., which makes the new tablet and funded the study, plans to apply for FDA approval of tablets for both ragweed and grass allergies next year. The grass tablets are already in use in Europe.
The new study was presented here at the annual meeting of the American Academy of Allergy, Asthma, & Immunotherapy.
The new study involved 565 adults with ragweed allergy, some of whom also had asthma. They were given one of two doses of either the once-daily tablet or a placebo for 52 weeks.
During ragweed season, which runs for about four to six weeks in August and September, everyone recorded their symptoms and need for relief medications in electronic diaries.
During the peak two weeks of the season, the tablet reduced symptoms -- including sneezing, runny and itchy noses, congestion, and gritty and watery eyes -- by 17% and 14% at the higher and lower doses, respectively, compared with placebo.
It also reduced the need for standard allergy medications at the two doses vs. placebo.
The most frequent side effects were throat irritation and itching of the mouth. No one died.
Two patients did need epinephrine, an injectable drug used to treat serious allergic reactions. However, one case was due to an unrelated reaction to peanuts.
Asked whether the tablets are as effective as shots, Creticos says a head-to-head comparison of the two is needed to really answer the question.
Mitchell Grayson, MD, an allergy specialist at the Medical College of Wisconsin in Milwaukee, tells WebMD that he welcomes a tablet, as some of his patients find shots annoying or painful. "And the tablets seem to be less likely to cause [life-threatening] reactions than the shots," he says.
One advantage to shots is that many different allergies can be treated at once, Grayson says.
"Most Americans are allergic to many different things, and with injections, you can pretty much cover all of them. So far, the tablets are each directed at different allergies -- one for grass, one for ragweed, for example. That wouldn't be very convenient for a person with [a lot of] allergies," he says.
Allergy shots typically are taken for about two to five years, after which many people can stop them and feel relief for years afterward, according to Grayson. It's not yet known for how long people will have to take the new tablets.
If approved, the tablets would only have to be taken for four months before, and during the four to six weeks of, ragweed season, Creticos says. They were given for 52 weeks in the study so the researchers could better assess their safety.
About 60 million Americans suffer from seasonal allergies, also referred to as hay fever and allergic rhinitis.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: 2012 Annual Meeting of the American Academy of Allergy, Asthma, & Immunology, Orlando, Fla., March 2-6, 2012.Peter Creticos, MD, associate professor of medicine, Johns Hopkins University, Baltimore; head, Creticos Research Group, Annapolis, Md.; consultant for Merck and other makers of immunotherapy products.©2012 WebMD, LLC. All Rights Reserved.
Knoxville Leads List for a Third Straight Year; 8 Out of 10 Top Spots Are in the South
By Cari Nierenberg
WebMD Health News
Reviewed by Laura J. Martin, MD
March 20, 2012 -- The third time is said to be the charm. But it's doubtful the allergy sufferers in Knoxville find it charming that for a third consecutive year their East Tennessee city has earned the No. 1 spot on the list of the worst places to live with spring allergies.
Knoxville natives have had plenty to sneeze at each spring. In 2009, Tennessee's third largest city placed second in this annual ranking of the 100 "most challenging places to live in the U.S. with spring allergies." And in 2008, the "Marble City" took the sixth spot in this listing, which is done twice a year -- in spring and fall -- by the Asthma and Allergy Foundation of America.
Several factors are considered when ranking each of the 100 largest metro areas, including pollen scores, number of allergy medicines used per patient, and the number of board-certified allergists per patient.
To top the list, Knoxville had "worse than average" pollen counts as well as utilization rates for allergy medications. But it received an "average" score on its number of allergy specialists available to treat patients with allergy-related symptoms, from runny noses and frequent sneezing to watery eyes and sinus congestion.
Here are the worst 10 cities for spring allergies:
Knoxville, Tenn.McAllen, TexasLouisville, Ky.Jackson, Miss.Wichita, Kan.Oklahoma City, Okla.Chattanooga, Tenn.Memphis, Tenn.San Antonio, TexasDayton, OhioFor a complete listing of the top 100 allergy cities for spring, visit allergycapitals.com.
The news that Knoxville has topped the list of most challenging places to live with spring allergies for a third time comes as no surprise to Allan Rosenbaum, MD, an ear, nose, and throat specialist in Knoxville who also treats allergy patients. "A lot has to do with the blessings of east Tennessee," he says.
"It's a beautiful place to live," explains Rosenbaum, "and few places in the U.S. have the variety of plant life." A great variety of trees are blooming right now in Knoxville, including its oaks, hickories, and some maples, he says.
And although spring begins today in terms of the calendar, the daffodils and tulips are already in full bloom. "It's very colorful," says Rosenbaum, and that also means an office filled with seasonal allergy patients, who are in sooner than usual from spring's early arrival in these parts.
It's not just the blooming trees and flowers that contribute to Knoxville's high pollen counts. The city is surrounded by mountains, located between the Smokies and the Cumberland Plateau, and it's also in the Tennessee Valley. That location causes pollen to get trapped in the region, where it can tickle the noses of Knoxville natives.
Rosenbaum says he is seeing more people coming in earlier for their allergy symptoms than last spring. He's also seen an increase in the number of people with seasonal allergies in middle age, who are dealing with hay fever for the first time in their lives.
For those with mild symptoms, he recommends a saline nasal rinse to reduce the pollen load and an over-the-counter allergy product. People with more severe symptoms should see their doctor for prescription medications.
SOURCES: Allan Rosenbaum, MD, ear, nose, and throat specialist, Knoxville, Tenn. News release, Asthma and Allergy Foundation of America.©2012 WebMD, LLC. All Rights Reserved.
Surveys: 1 in 3 Kids With Food Allergies Teased or Harassed
By Charlene Laino
WebMD Health News
Reviewed by Laura J. Martin, MD
March 9, 2012 (Orlando, Fla.) -- Parents of kids with food allergies should be aware that their children may be teased or harassed because of their condition, experts say.
Some bullies even chase kids with the allergy-producing food or throw it in their faces, says A. Erika Morris, MD, of the University of Mississippi Medical Center in Jackson.
She headed one of two surveys that showed that about 1 in 3 food-allergic kids is taunted or physically abused at school due to their allergies.
That figure is "only a little out of proportion" to the number of children overall who are teased or bullied by their classmates for everything from their weight to their hairstyle, says Todd Mahr, MD.
Mahr, director of pediatric allergy/immunology at the Gundersen Lutheran Medical Center in La Crosse, Wis., and chair of the American Academy of Pediatrics' allergy & immunology section, reviewed the findings for WebMD.
"But it's something most parents -- and a lot of us who take care of food-allergic kids -- don't think about," he says.
Indeed, one of the surveys showed that 32% of parents of kids harassed about their food allergies were unaware of it.
Not surprisingly, classmates and siblings most often did the bullying, both surveys showed. But in a few cases, teachers or other adults were to blame.
The surveys were presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology.
The findings come at a time when both bullying and food allergies in kids are on the rise. In 2007, about 1 in 3 middle school and high school students reported having been verbally or physically abused at school, an increase of 17% since 2001. Nearly 4% of children reported food allergies in 2007, an increase of 18% since 1997.
Morris and colleagues administered a 16-question survey to 32 food-allergic children or their parents in the Jackson, Miss., area; 81% were aged 5 to 11 years. Most were allergic to peanuts or eggs.
Results showed that 11 children, or 34%, had been bullied: Ten of the cases involved verbal teasing and six involved physical abuse, including being pushed, tripped, hit, or struck by the offending food.
"One child had an allergic reaction as a result," Morris tells WebMD.
Eight of the 11 children had also been bullied for other reasons, including their size or age.
The second survey, led by Scott Sicherer, MD, of Mount Sinai Medical Center in New York City, involved 111 food-allergic children aged 8 to 17 in that city. Their parents were also surveyed.
Overall, 29% were "bullied, harassed, or teased" due to their food allergies.
Sicherer's previous survey, in 2010, was the first to show that food allergies can make kids -- and adults -- a target of bullying.
While much larger surveys are needed to draw firm conclusions about the proportion of kids bullied due to food allergies, the findings sound a cautionary note for parents, Mahr says.
"Open a dialogue with your child so they know it's OK to talk to you about the problem. A lot of kids are embarrassed to mention being teased or abused, or are afraid their parents will make the situation worse," he says.
Also, "talk to the staff at school to ensure they know about the potential problem. It's important to deal with this early so it doesn't become a pattern," Mahr says.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: 2012 Annual Meeting of the American Academy of Allergy, Asthma & Immunology, Orlando, Fla., March 2-6, 2012.A. Erika Morris, MD, fellow, University of Mississippi Medical Center, Jackson, Miss.Scott Sicherer, MD, assistant professor, pediatrics, Jaffe Food Allergy Institute, Mount Sinai Medical Center, New York City.Todd Mahr, MD, director, pediatric allergy/immunology, Gundersen Lutheran Medical Center, La Crosse, Wis.; chair, allergy & immunology section, American Academy of Pediatrics.©2012 WebMD, LLC. All Rights Reserved.