Allergen immunotherapy is a form of treatment that desensitizes your body to the environmental allergens you may be allergic to including pollens, dust mites, animals, and insect venom. Patients on allergen immunotherapy experience a decrease in their allergic symptoms over time. There are two forms of allergen immunotherapy that are offered in our clinic: allergy shots and sublingual immunotherapy.
Allergy shots involve injecting you with what you are allergic to so that your body becomes desensitized to it (slowly gets used to it and no longer thinks of it as a foreign body). Through time, your symptoms will decrease with the hope of using less medications.
Sublingual immunotherapy (SLIT) is an alternative way to treat allergies at home and without injections. Patients administer drops of pre-prepared allergen mixes under the tongue to develop tolerance to the substance and reduce allergy symptoms.
How long do I have to be on allergen immunotherapy?
Studies show continual treatment for a period of 3-5 years is needed to develop lasting immunity.
Has the medical literature shown this to be effective?
Yes. Through evidence based medicine this has shown to be highly effective for hay fever and to help improve allergic asthma.
DESCRIPTION: Cinqair is administered through an intravenous infusion (IV) once every four weeks to treat the eosinophilic phenotype of asthma (subtype of asthma). Each infusion takes about 20 to 50 minutes and must be given at a doctor’s office or an infusion center.
What are the risks associated with Cinqair?
The most serious reaction that can occur when receiving Cinqair is anaphylaxis. Anaphylaxis is a life-threatening condition which requires immediate medical attention. Swelling of the face, lips, mouth, or tongue, fainting, dizziness, confusion, fast heartbeat, skin rashes such as hives, and nausea or abdominal discomfort may also occur. Abnormal growth of cells or tissue in your body that may or may not be malignant can occur in patients who have received Cinqair (0.06% change compared to placebo of 0.03%).
What are the most common side effects of Cinqair?
The most common side effects include throat pain.
What are particular things to tell your healthcare provider before receiving Cinqair?
Please tell your healthcare provider if you are taking oral or inhaled corticosteroid medicines, have or have had cancer, have a parasitic infection, are pregnant or plan to become pregnant, and/or are breastfeeding or plan to breastfeed.
DESCRIPTION: Drug allergies can be life threatening but sometimes it may be necessary for you to take a certain medication (i.e. blood pressure or cholesterol lowering medication, antibiotics, or aspirin). Drug desensitization involves the gradual reintroduction of small doses of the drug antigen at fixed time intervals. The gradual reintroduction protects the patient from anaphylaxis and permits the delivery of essential medications at their therapeutic dose.
How long does drug desensitization take?
Drug desensitization usually takes place in a hospital setting, typically the intensive care unit, for safety purposes. The drug is administered in escalating doses over the course of a few hours to even a full day. The patient is usually required to stay at the hospital overnight to monitor their vital signs.
How long will I be “desensitized” to the drug?
The desensitization effect will only last as long as the patient is taking a daily dose of the medication.
Is drug desensitization safe?
Yes. A team, consisting of two consultant physicians—usually an allergist and pulmonologist—and an admitting physician, and specially trained nurses will monitor the patient closely during the drug desensitization process. The team is professionally trained to respond if the desensitization does trigger a life-threatening reaction.
DESCRIPTION: Dupixent is a subcutaneous injection that is administered once every two weeks to treat moderate-to-severe atopic dermatitis (eczema), moderate-to-severe asthma, or chronic rhinosinusitis with nasal polyposis. The first dose must be administered at the physician’s office and consists of two injections. All subsequent injections (one injection every two weeks) may be self-administered at home after the patient is properly trained at our office.
What are the risks associated with Dupixent?
The most serious reaction that can occur when receiving Dupixent is keratitis of the eye (inflammation of cornea). Other reactions may include fever, general ill feeling, swollen lymph nodes, hives or skin rash, joint pain, conjunctivitis, blepharitis, oral herpes, eye pruritis, other herpes simplex virus infections, and dry eye.
What are the most common side effects of Dupixent?
The most common side effects include injection site reactions, eye and eyelid inflammation, including redness, swelling, and itching, and cold sores in your mouth or on your lips.
What are particular things to tell your healthcare provider before receiving Dupixent?
Please tell your healthcare provider if you have eye problems, have a parasitic infection, have asthma, are scheduled to receive any vaccinations, are pregnant or plan to become pregnant, and/or are breastfeeding or plan to breastfeed.
Fasenra (benralizumab) – for severe asthma with eosinophilic phenotype (ages 12+)
DESCRIPTION: Fasenra is a subcutaneous injection to treat severe eosinophilic asthma for patients 12 years or older. The first three injections are administered once every 4 weeks and subsequent injections are once every 8 weeks. It works to improve breathing and decrease asthma attacks by reducing eosinophils (white blood cells that may be inducing your asthma).
What are the risks associated with Fasenra?
Fasenra could cause an allergic reaction, the most severe of which would be an anaphylactic reaction that can be identified by symptoms of breathing problems, coughing, wheezing, shortness of breath, or chest tightness. An allergic reaction could also result in swelling of the face, mouth or tongue as well as rash, hives, or feeling lightheaded or dizzy.
What are the most common side effects of Fasenra?
The most common side effects of Fasenra are having a sore throat or a headache.
What are particular things to tell your healthcare provider before receiving Fasenra?
Before moving forward with Fasenra, be sure to discuss with your doctor if you have a parasitic (helminth) infection. Also be sure to notify your provider if you are pregnant or plan to become pregnant, or are breast feeding.
DESCRIPTION: Immunoglobulin (IgG) replacement therapy may be a suitable option for those with primary immunodeficiency. IgG, also known as antibodies, are molecules that play an important role in your immune system. They recognize and bind to foreign and harmful antigens in your body and aid in their destruction. However, those with immune deficiencies may have impaired or a lack of antibody function. IgG replacement therapy involves commercially preparing IgG for patients and injecting those antibodies either intravenously or subcutaneouslyl. Based on the physican’s evaluation, he can determine whether an intravenous or subcutaneous route of injection is best for you.
How is the IgG prepared? And is it safe?
The IgG is prepared from the plasma collected from normal individuals who are screened to make sure they are healthy. The IgG collected is very safe because the donors must meet the criteria and strict guidelines enforced by the American Association of Blood Banks and the U.S. Food and Drug Administration (FDA). The IgG is purified and and the plasma is carefully tested for any infectious diseases.
How often and for how long do I have to receive the IgG infusions?
Since the IgG administered may be metabolized by your own immune system, the source must be constantly replenished. Repeat doses are often required at regular intervals. Depending on how your body reacts to the IgG, you may need infusions weekly or as often as every 1 to 3 days. Each infusion session may last from 2 to 4 hours from start to finish. IgG therapy only replaces what is missing from the immune system and does not act to correct antibody production; therefore, patients may have to receive the infusions for a lifetime.
What are the routes for IgG injections?
There are 2 methods for IgG injections: subcutaneous or intravenous. Subcutaneous Immunoglobulin therapy (SCIG) involves giving injections directly under the skin. Intravenous Immunoglobulin therapy (IVIG) involves giving injections into the vein. Depending on how you may react to the different types of injections, medical history, or insurance coverage the physician can discuss with you the best method.
Where can I receive IgG infusions?
You may receive the infusions at an outpatient clinic or even at your own home. We work with a third party infusion company and take into account you insurance coverage to provide you the best treatment options.
What are the common side effects from IgG replacement therapy?
Many patients tolerate IgG infusions very well. Some common side effects include a low-grade fever, aching muscles, and headaches. Less often, patients may also experience local skin irritation and swelling that subside in 1-2 days.
What are the risks associated with NUCALA?
The most severe reaction that can occur when receiving Nucala is anaphylaxis. Anaphylaxis is a life-threatening condition which requires immediate medical attention. Swelling of the face, mouth, and tongue, fainting, dizziness, hives or a rash may also occur. Herpes zoster infections that cause shingles have happened in people who have received NUCALA.
What are the most common side effects of NUCALA?
The most common side effects are headaches, pain, swelling or itchiness at the site of injection, back pain and/or fatigue.
What are particular things to tell your healthcare provider before receiving NUCALA?
Please tell your healthcare provider if you have had a parasitic infection, have not had chickenpox (varicella) or the chickenpox vaccine, are taking oral or inhaled corticosteroids, are pregnant of plan to become pregnant, and/or are breastfeeding or plan to breastfeed.
Oral Food Immunotherapy
DESCRIPTION: Oral Immunotherapy (OIT) is a new therapy that involves the daily ingestion of a certain food allergen in increasing doses until a “maintenance dose” is reached. Patients treated with OIT become “desensitized” over time, meaning that their body has been exposed to this food allergen so much that it no longer views the allergen as foreign and does not mount an allergic response to it.
PALFORZIA™ is the first FDA-approved oral immunotherapy product for the treatment of peanut allergy. The goal of this treatment is to reduce allergic reactions, including anaphylaxis, that may occur with the accidental exposure to peanuts. Make an appointment with your allergist today to find out more about this new therapy.
Has the medical literature shown this to be effective?
Yes. OIT has shown to be highly effective in desensitizing patients to food allergens.
Will OIT allow me to eat the food I am allergic to?
TOITs, like PALFORZIA™, are to be used in conjunction with avoiding the food you are allergic to. The goal is to reduce the occurrence of allergic reactions upon accidental exposure to the food allergen.
DESCRIPTION: Omalizumab (Xolair) is subcutaenous injection that is administered once or twice a month to help treat moderate to severe persistent asthma and/or chronic urticaria (hives).
CONDITIONS: Xolair will aid in the management of: asthma and/or idiopathic chronic urticaria.
What are the risks associated with Xolair?
The most severe reaction that can occur when receiving Xolair is anaphylaxis. Anaphylaxis is a life-threatening condition which requires immediate medical attention. Xolair should only be administered in a healthcare provider’s office where you can be closely monitored for symptoms of wheezing, shortness of breath, low blood pressure, dizziness, fainting, itching or hives. The risk of anaphylaxis is extremely low ranging from 0.09% to 0.2%.
How do I know if I am qualified to receive Xolair? And what are the costs?
We can work with your insurance company to see if you qualify for assistance based on your income. If you qualify, you may be eligible to receive Xolair injections at a low cost.
What are the most common side effects of Xolair?
Asthma patients note having pain in arms and legs, dizziness, fatigue, and rash. Chronic idiopathic urticaria patients note having nausea, headaches, swelling in the sinuses and throat, cough and upper respiratory tract infections.