| An Algorithm for
Allergic Disease: When to Consider Allergy Immunotherapy
Allergic Diseases,
specifically Allergic Rhinitis and Allergic Asthma
are common. Most patients will
try various over-the-counter medications before seeing
their doctor.
Many will experience some relief at
this first line of therapy, although these patients
should be warned that many of these medications are
associated with sedation and cognitive impairment.
The primary care physician can offer additional medications,
including non-sedating antihistamines and nasal corticosteroids.
The physician can also try to identify the asthma
triggers through history and recommend environmental
controls to limit exposures to allergens. Pollen
allergy may be identified by seasonal symptoms which
are worse outside during a pollen season (Trees begin
pollinating in early spring, and persist through
June. In this area Grass pollens spike in April,
but can persist in lower levels into the autumn.
Weeds begin pollinating in late summer through early
autumn).
Closing the windows and using the air conditioning
will decrease the pollen exposures. Avoiding the
outdoors is also effective, but would be unacceptable
to many people and would interfere with our efforts
as physicians to encourage our patients to be more
active.
Allergy Immunotherapy
Allergy Immunotherapy is also a safe and effective
option that you should consider for your patients
with Allergic Rhinitis, especially if they do not
experience significant relief from the other treatment
options. Some patients may prefer immunotherapy because
of the high cost of medications, or they may prefer
not to rely on medications for their relief.
Even
if you find an effective medication, there is a chance
that it may fail in the future. You may also want
to consider immunotherapy for patients who have other
related diseases, such as asthma or sinus disease.
Children
with Allergic Rhinitis are at a higher risk of developing
allergic asthma, and Allergy Immunotherapy
has been demonstrated to significantly reduce the
development of asthma in these patients. While the
other treatments for Allergic Rhinitis focus on symptom
control, allergy immunotherapy targets the cause.
It can make the patient less allergic and often effects
a cure.
The biggest downside to allergy immunotherapy
is that it is often inconvenient for patients to
come in for routine injections, but most patients
are able to go 3-4 weeks between injections after
the first year, and even less frequently after that.
Also, most patients are able to discontinue allergy
injections after 3-5 years and still maintain the
benefit for many years later.
About The Author
Gary B. Moss M.D
www.allergydocs.net
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