Autumn of 2014 is a long time off, but ragweed sufferers can probably start looking forward to what was always the most dreaded of all allergy seasons.
A new national study that included Allegheny General Hospital researchers has found that daily liquid medication under the tongue -- sublingual drops -- is as effective as weekly visits to a doctor's office to get allergy shots.
The clinical trial, which is in its final stage, was conducted jointly with researchers from around the country and found that oral immunotherapy is as safe and effective as injections for ragweed, which plagues more than 36 million Americans annually.
The study looked at 429 patients ages 18-55 with ragweed-related allergies, which cause congestion, sneezing, itching and other discomforts. The participants were selected randomly to receive either the liquid medication or a placebo -- but were not being given allergy shots at the same time.
Both the shots and the drops contain liquid extracts of allergens and, given in tiny amounts, build up resistance. Patients in the new study reported greatly improved symptoms after taking the drops every day for about two months to four months and through the end of the pollen season, which for ragweed ends in Pittsburgh around mid-October, or at the first hard frost.
About 30 participants were enrolled through Allegheny General, said Deborah Gentile, one of the lead authors and director of research at the hospital's Division of Allergy, Asthma and Immunology.
Europeans have been using the sublingual drops for years, "and in general they're about 15 years ahead of us in terms of drug development," said Dr. Gentile, noting that the United States may have lagged behind because many allergists were trained to use injections, which require office visits and are typically given for three to five years.
Also, she added, "perhaps there was a perception that this was homeopathy," a controversial alternative treatment with many skeptics in the medical establishment, in which minute doses of an offending substance are given to trigger the body's natural healing ability.
Despite the widespread prevalence of over-the-counter anti-allergy medications, pharmaceutical companies have been funding substantial research for some time into sublingual drops.
This randomized, placebo-controlled study was constructed with the assistance of the Food and Drug Administration, which may be prepared to approve the treatment in the next six to 12 months, Dr. Gentile said. It was funded in part by Greer Laboratories, a pharmaceutical company in North Carolina, and with federal funds.
It is important, of course, that patients be compliant and not forget to take the drops every day, noted Andrej Petrov, medical director of Allergy and Clinical Immunology at the University of Pittsburgh School of Medicine. "The treatment looks promising," he said, but added it's not known how effective the therapy will be in patients with multiple allergen sensitivities, given that most patients are not allergic to ragweed only.
While nasal steroid sprays remain the most important medical treatment for patients with allergic rhinitis, they work as anti-inflammation drugs and "don't change our immune system by inducing long-term tolerance of environmental allergens," he added.
As far as what's to come this spring, Allegheny General Hospital will begin tracking pollen in the air next week on its roof counter, added Dr. Gentile -- unlike last year, when pollen was detected there Feb. 23, the earliest since records began being kept. Tree pollen counts usually start in early April, peak in late April and early May and disappear by Memorial Day.
To find the Pittsburgh pollen counts, see www.aaaai.org/global/nab-pollen-counts.aspx.
Mackenzie Carpenter 412-263-1949; firstname.lastname@example.org; on Twitter at MackenziePG.