On Tuesday, April 1, 2014, the FDA approved Oralair, a grass tablet for sublingual use. Initial reports show it will be indicated for those ages 10-65 with seasonal allergic rhinitis with or without conjunctivitis and a confirmed positive skin test or blood test to any the following grasses: timothy, Kentucky bluegrass, perennial rye, orchard and sweet vernal. Oralair, once available, should be dosed once daily and held under the tongue until fully dissolved. Treatment should begin four months before grass season and continued until grass season ends. Additionally, the first dose should be administered in a physician’s office where the patient can be monitored for a period of time after administration. Patients should be prescribed injectable epinephrine and counseled on the signs and symptoms of an anaphylactic reaction. Clinical studies showed an improvement in symptoms between 16 and 30%. It is not without risk, as one-third of adults had oral itching with its use and 12% of kids had mouth swelling.
This is the first sublingual immunotherapy product to be approved by the FDA. There are other sublingual tablets in development including ones for dust mites, ragweed and an additional grass tablet.
It does not appear to be as effective as traditional allergy shots, but head to head studies are lacking. Cost and insurance coverage will definitely affect prescribing habits.
Call our office to get allergy tested and see if this new treatment is right for you. We’ve missed the window for the 2014 grass season in the Louisville area, but use will likey increase in subsequent seasons.
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Disclaimer: This blog is not intended to create a doctor-patient relationship with any reader. If you need personalized medical advice, contact your primary care physician or other physician in your community. If you need to establish care with an allergist, Allergy Partners of Louisville would love to help you find relief. Call 502-882-2063 for an appointment.