Desensitization has modernized. Effective against pollens and dust mites, this basic allergy treatment can now be done sublingually.
- Desensitization is done today by drops or tablets
- It must be started 4 months before the pollen season
- It is also very effective against asthma caused by dust mites
- Allergics take 7 years, on average, before going for a consultation
After Toulouse, it is Lyon which on May 2 will be confronted with the beginning of pollination of grasses. A test for allergics who have already suffered an episode of red alert over almost all of France because of the high levels of birch pollen. However, to avoid a itchy throat, itchy eyes or a runny nose, solutions exist. As a first step, patients can treat symptoms with antihistamines or eye drops.
But if the gene persists and comes back every year, they can also turn to so-called “basic”, preventive treatments. Desensitization or immunotherapy, has made great progress and is today a method considered very effective by specialists.
Drops or tablets rather than the injection
Met on 10e Francophone Congress of Allergology, which took place from April 21 to 24 in Paris, on Prof. Alain Didier, head of the respiratory tract pole at the Toulouse University Hospital, explains what this method consists of. Its principle is simple: “We administer to allergic patients the product to which they are sensitized to induce, not signs of allergy, but what is called tolerance”. As a result, as the doctor administers the product in increasing doses, the allergic person sees their symptoms disappear or at least improve when they are exposed to allergens, pollens, mites, etc.
In practice, two possibilities of immunotherapy exist. “The historical, old in France”, as Professor Alain Didier says, is done by injection. But for 10-15 years, doctors have also used sublingual desensitization. The product is administered in the form of drops or tablets. For this to be effective, especially for pollens, the treatment must be taken several weeks before the pollen season. “In practice, the best is four months before,” advises Professor Alain Didier.
It is therefore already too late for this season, and those most inconvenienced by allergies will therefore have to wait until next December.
Prof. Alain Didier, pneumo-allergist at Toulouse University Hospital: “Ona much switched to the sublingual route. The patient does it at home. In addition, it has no serious side effects while with the injection route you had to be careful. “
Efficacy validated in large studies
This specialist, president of the Société de Pneumologie de Langue Française (SPLF), adds: “This more practical method for the patient has also demonstrated its effectiveness very clearly, especially for grass pollens which are really the ones that bother us. most in France. It also works for other pollens such as birch, quite virulent pollens in the North-East of France. And then we now have fairly solid data for dust mites, allergens present all year round, which can cause asthma attacks. Today, we have validations of this sublingual method in several European studies carried out in a large number of patients. “
As a result, after desensitization, most patients have less annoying symptoms, and above all they have less need to resort to antihistamines, or corticosteroids.
Prof. Alain Didier : ” Two large studies show that once you quit you continue to benefit for at least 2 more years. We are always less symptomatic than before desensitization and …. “
An effective method in asthma caused by dust mites
Better still, desensitization would have spectacular effects against asthma due to dust mites. “There, we leave the field of allergic rhinitis to enter asthma, a disease even more troublesome than rhinitis. There really are studies with high levels of evidence and a lot of patients included. Immunotherapy has thus shown in this work that it can reduce the long-term treatment of asthma (often inhaled corticosteroids) and that it also reduces the frequency of asthma attacks. Preliminary results for which the experts await the publications. “But these are all the same very interesting studies carried out in France and in other European countries”, underlines Professor Didier.
Prof. Alain Didier : ” We are very happy to see that desensitization also works in asthma with an allergic component. We can think that these studies will be retained by the authorities to validate the treatment. . “
Patients wait 7 years on average
To conclude, Alain Didier would like to remind patients who neglect their allergies: “In some cases rhinitis can become complicated and turn into asthma. This is why it is necessary to go to consult early. And, even if it is too late for this spring, patients can already go to an allergist to get tested and identify the substances to which they are allergic. “A useful anticipation to then very quickly initiate the right treatment”, concludes the allergist. A prevention message that few French people listen to since an allergic patient takes an average of 7 years before going to see a doctor.
Immunotherapy: from when? Until what age?
Desensitization can be done from 5 years old. The age when the child is able to put tablets or drops under the tongue. For the upper limit this is not well defined. The doctor will act according to the duration of the disease. According to specialists, if hay fever or allergy (to pollen for example) is recent, initiating immunotherapy is useful. For those who would be tempted, know that the treatment must always be initiated by an allergist, the only professional competent to make the diagnosis. Then, the follow-up will be carried out by a general practitioner.
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