Allergen and biological immunotherapy

Immunotherapy is meant to train the body's immune system not to react to certain allergens. This treatment might protect broadly against allergens that are hard to avoid such as pollens, dust mites and molds. Biologic medicines make changes to the body's immune system to treat allergic conditions such as asthma, sinusitis, hives and food allergy.

Immunotherapy is carefully timed and monitored while exposure to allergens is slowly increased. Immunotherapy might be useful in several cases, especially when other treatments aren't effective or tolerated.

Shots

Immunotherapy may be given as a series of shots, also called injections, usually one or two times a week. The dose may be increased during this time based on a person's tolerance. The highest tolerated dose can then be given year-round every 2 to 4 weeks.

Side effects might include irritation at the injection site and allergy symptoms such as, sneezing, congestion, hives, and itchy or watery eyes. Rarely, allergy shots can cause anaphylaxis.

Biological medicines given by injection include:

• Dupilumab (Dupixent). This medicine treats asthma, sinus pressure and allergic skin conditions.
• Omalizumab (Xolair). This medicine treats asthma or hives when other medicines don't help.
• Mepolizumab (Nucala). This medicine treats asthma and sinus discomfort.

Pills and liquids

When treating a peanut allergy in children, a pill might help. Although peanuts may still need to be avoided, this medicine might help prevent a severe reaction if peanuts are eaten by accident. It cannot be used as emergency treatment for anaphylaxis.

Side effects include swelling of the throat and anaphylaxis in rare cases. If you have asthma, this treatment may make your symptoms worse.

Oral treatment for peanut allergies:

• Peanut allergy powder (Palforzia).

When treating for dust mites or hay fever, a medicine tablet may be placed under the tongue. This is called sublingual immunotherapy (SLIT). The medicine dissolves and is absorbed under the tongue. This method is known to relieve asthma and allergy symptoms.

SLIT treatment for dust mites:

• House dust mite allergen extract (Odactra).

SLIT treatments for hay fever:

• Short ragweed pollen extract (Ragwitek).
• Sweet vernal, orchard, perennial rye, timothy, and Kentucky blue grass mixed pollens allergen extract (Oralair).
• Timothy grass pollen allergen extract (Grastek).