Playing outside can be hard if children have a grass allergy and suffer from constant runny noses, watering eyes and sneezing every time they go outdoors in late spring or early summer.
In the past, the only options to treat seasonal allergic rhinitis caused by grass pollen were through injections – and kids are often afraid of needles– or through over-the-counter medication, which can bring on drowsiness. Not all parents are aware, however, of a new and effective oral treatment, sublingual immunotherapy (SLIT), tablets that dissolve under the tongue. They can be taken by children as young as five.
Immunotherapy addresses a patient’s underlying sensitivity and can actually change their immune system. Patients are exposed to increasing amounts of the allergen, either through injections or sublingually, in the hope that they will eventually become desensitized and show fewer or less severe symptoms.
“Hopefully you are actually changing things for the future to make the patients less allergic to grass over the long-term,” says Allergist Dr. Sandy Kapur, President of the Canadian Society of Allergy and Clinical Immunology. After three seasons patients can stop taking the tablets and have up to two years of relief.
Safer, more convenient and more comfortable treatment
Because there’s no injections involved with sublingual immunotherapy, it has a “huge advantage” for pediatrics, says Dr. Kapur. Allergist and Clinical Immunologist Dr. Susan Waserman points out that “unlike needles, there’s no pain or large local swelling when you are putting a tablet under your tongue.”
An additional benefit of SLIT is that it can be done at home after the patient has an initial doctor’s visit, making it much more convenient for families, who might otherwise have to visit their doctor regularly for allergy shots.
As well, Dr. Kapur notes that patients generally tolerate tablets much better than injections and have fewer severe reactions. Anaphylaxis occasionally occurs with injections but is “exceedingly rare with SLIT,” he says.
Don’t skip treatment
Dr. Waserman notes that parents need to ensure that children take the tablet every day. Once a person misses a couple of days, their body may lose the ability to tolerate that tablet as well, and it’s as if you are initiating treatment for the first time, she says. A minor side effect of SLIT is mild oral symptoms, such as itchiness, which usually only lasts for about 15 to 20 minutes and typically disappears after the first few treatments.
SLIT has been used in Europe for over 10 years, although there the therapy previously involved putting drops under the tongue. Dr. Kapur notes that the tablets are more standardized than the drops and have been better studied. He also adds that because grasses in Canada cross-react quite well, one tablet will take care of all grass allergies. “If you are allergic to one grass, you’re allergic to them all,” he says, adding that about 10 to 15 percent of Canadian suffer from seasonal allergies.
For allergy sufferers who are very symptomatic it can be “hard to work, hard to play, and hard to spend time outdoors,” says Dr. Waserman. In addition to the typical allergy symptoms, some patients may also find that these symptoms affect their sleep, leading to fatigue and poor concentration, she notes, adding that some people exposed to grass pollen may even develop or worsen existing asthma.
Not treating allergies properly “can have a tremendous effect on how people perform and live and work and go to school.”