Tablets mark latest shift in immunotherapy, could make allergy shots unnecessary for many
Thanks to the timely approval of a new tablet by the Food and Drug Administration (FDA), millions of Americans who suffer from ragweed allergies will have a new, at-home option for treatment this fall.
It’s estimated that more than 17 million Americans suffer from outdoor allergies, many of whom suffer during ragweed pollination season, which typically runs from August through November. Ragweed allergies are prevalent in every state except Alaska and cases are usually worse in the midwest and eastern parts of the country.
“This is a great change in the approach to immunotherapy,” said Harold Nelson, MD, who helped study the effectiveness of the tablets at National Jewish Health in Denver. “This tablet does the same thing as an allergy shot. It delivers large amounts of antigens to the immune system and aims to convert the immune response to these pollens back to normal,” he said.
The tablets are placed under the tongue and dissolve almost immediately. Antigens then enter the body and are engaged by the immune system. “You wind up getting about as much antigen every day as you would once a month in an allergy shot,” said Dr. Nelson.
The primary difference is that, because absorption is much less efficient under the tongue than it is through injections, the tablets will have a much higher concentration of antigens. Compared to a shot, “it’s about 30 times as much extract that you receive,” said Dr. Nelson.
The idea of simply taking a tablet each morning to control her allergies is something Melissa Lilly of Highlands Ranch, Colo., has dreamed about. “I would love a pill. That would make my life so much easier,” she said.
Currently, Lilly has to get two different allergy shots every other week, which can be a challenge. “It’s easily an hour and a half to a two hour process for me to take time out of my day to go get my shots,” she said. “To try to fit that in between work, getting the kids to their school activities, having dinner at a reasonable hour and getting homework done, it’s tough to fit it all in,” she said.
Many other patients are in similar situations, which is where the convenience of a tablet would help. Although Dr. Nelson is quick to point out that while the tablet may be easier to take, there is no evidence to suggest they work any better than a shot.
“Direct comparisons of shots and tablets have not been done, so there really isn’t anyway to say that one is more effective than the other,” he said. “But we are moving in a new direction with immunotherapy, and this is likely just the beginning.”
In fact, tablets are already in development to treat other popular allergies, like those to cat dander and dust mites. “Those are a few years away still, but they’re coming,” said Nelson.
Meantime, those who hope to use the new tablets to control their ragweed allergies this fall, should talk to their doctor now about a prescription.
“These tablets have to be started about four months before the beginning of pollen season in order to get benefit,” said Dr. Nelson. “So, it’s essential that patients start their therapy now so they won’t be miserable this fall.”
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