Did you know there is a new under the tongue tablet NOW available for treatment of house dust mite allergy?

Struggling with hay fever, asthma or allergic eye symptoms? You are not alone. 1 in 5 Australians suffer from allergies. Finally there is a new era of allergy treatments available for patients suffering from allergies.

One of these new treatments is a new house dust mite allergy tablet. This month, Actair was launched heralding a milestone in specific house-dust mite allergen immunotherapy. So if you thought you had to put up with runny nose, sneezing fits and blocked nose and sinus symptoms forever, you are wrong. New allergy treatments are starting to emerge to catch up with the global airborne allergy epidemic.

It is broadly accepted we are amidst a worldwide increase in the prevalence of allergic disease especially asthma and hay fever. Although the complications of the increase in respiratory allergies are increasing, there are treatments now available to help. Although the first line management of allergic disease includes educating the patient to avoid exposure to the allergen and pharmacological treatments such as nasal steroids for symptom relief, the only really curative treatment modality is allergen specific immunotherapy.

What many people don’t realise is that although immunotherapy might seem like a bigger investment in terms of initial outlay of costs compared with over the counter medications, they are investing in a more long term solution for their health. Over the counter relief treatments and “rescue” medications such as antihistamines or nasal sprays and rinses over an allergy lifetime can total up to be very expensive to patients, therefore it is shortsighted for patients not to consider the overall health and monetary value when considering immunotherapy.

Moreover, immunotherapy for pollens or dust mite has the capacity of changing the natural course of allergic disease for patients by preventing sensitizations with new allergens and development of asthma in patients with rhinitis. And that’s a fact. Studies show that Allergy immunotherapy for allergic rhinitis effectively prevents asthma and especially so for children. Yes, there is evidence we can prevent the allergic development of asthma! Longitudinal studies have confirmed that sensitization to HDM is one of the most important risk factors for the development of asthma in children.

Given the increase in HDM-induced allergic rhinitis and asthma, then more attention should be given to treatments such as immunotherapy which can be easily and safely administered.

Whilst allergy injections (subcutaneous immunotherapy) has long been used for allergy treatment, discomfort and adverse reactions have meant alternative routes have emerged. The alternative of under the tongue mucosal route of drops (sublingual immunotherapy) and now oral dispersible tablets has meant patients have a safer more convenient way to manage their allergies.

The under the tongue oral tablet allergy treatments to treat allergies first started with the emergence of pollen allergy tablets. There are multiple studies demonstrating patients with allergic rhinitis and or asthma improving using a standardized grass pollen tablet over the last few years and showing safety, tolerability and clinical efficacy.

Now, Actair, the new House Dust mite oral tablet immunotherapy has launched and preliminary studies are indicating that symptoms scores improve and stay improved even after one year after ceasing treatment. In a European study, individual symptom scores were markedly improved for sneezing, itching and nasal congestion by 22.2% reduced compared with placebo group (9.7%).

A significant symptom score improvement of 23% was demonstrated in the Rhinoconjunctivitis quality of life questionnaire after the first year compared to the placebo group. Results such as these are promising and although there are no long-term studies after one year or data for over 65 or under 5-year-olds available as yet for Actair, this is definitely a step in the right direction to providing patients with more choices for allergy treatment.

Fast Facts
– ACTAIR is a new house dust mite allergen extract tablet now available
– It is a form of allergen immunotherapy or desensitization treatment aiming to cure of dust mite allergy
– It’s an easy-to-use tablet – given daily under the tongue, which dissolves in two minutes and then can be swallowed
– Treats allergic rhinitis (hay fever) with or without conjunctivitis and allergic asthma that is triggered by house dust mites diagnosed by an allergy test
– ACTAIR contains a mixture of American (Dermatophagoides farinae) and European (Dermatophagoides pteronyssinus) house dust mite allergen extracts

The science of it
Actair works by re-educating the body’s immune system by actually targets the cause of allergy rather than just treating allergy symptoms with medications. It is a form of immunotherapy, which means desensitization. Allergen immunotherapy changes the way the immune system reacts to allergens, by switching off the allergy. The end result is that you become immune to the allergens, so that you can tolerate them with fewer or no symptoms.

Who can use Actair:
Adults and children can use the tablet over 12 who have been diagnosed with dust mite allergy.

How will it help my dust mite allergy?
Actair has been shown clinically to reduce the occurrence and severity of allergic symptoms such as runny nose, blocked nose, sneezing fits, itchiness of the nose, throat and eyes and asthma exacerbation.
Studies also show it reduces the use of rescue medications for flares and improves the quality of life.
For many patients whose HDM allergy this means an improvement in their snoring, mouth breathing and sleep.

How quickly does it work?
Works as quickly as 4 months.

How long does it last?
Unknown. At this stage there appears to be only one year follow-up data available.

How to buy it?
– Actair is TGA-registered in Australia
– It is Not PBS listed yet but available on PRIVATE SCRIPT from your doctor
– readily available in Australia at chemists and allergy clinics ( unlike many immunotherapy treatments which can take 8-12 weeks to be received upon ordering from overseas)
– Health fund rebates are available for private scripts but obviously, depends on your levels of cover.
–

How Do I start
If you have allergy symptoms we recommend an allergy assessment by an allergy trained doctor. Skin Prick testing is the gold standard method to diagnose dust mite allergy. Your Doctor will then recommend a treatment plan for your allergy. Actair is only one option available for management of dust mite allergy and your Doctor will assess your suitability for this medication or whether other treatments options are better for your health.

At Australian Allergy Centre our Doctors are allergy trained GP’s who require no referral and there is no wait for allergy assessment. We have Doctors available that bulk bill consultations and bulk bill skin prick testing for air allergies as well as other nose lab tests.

We offer education on avoidance measures, medical treatments, Rhinolight treatments and immunotherapy. For complex cases or those who require assessment with an ophthalmologist for eye symptoms or ENT for nose and sinus symptoms, our specialists assist with consultations. If you would like to make an appointment to see one of our Doctors you can call 1300 344 325 or book online.

references:
Bacharier LB, Boner A, Carlsen KH et al. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy. 2008;63:5-34
Schmitt J1, Schwarz K2, Stadler E2, Wüstenberg EG3. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: Results from a large retrospective cohort study. J Allergy Clin Immunol. 2015 Dec;136(6):1511-6. doi: 10.1016/j.jaci.2015.07.038. Epub 2015 Sep 12.
Host A, Halken S. The role of allergy in childhood asthma. Allergy 2000;55 (7):600-8
Maloney J, Bernstein DI, Nelson H et al. Efficacy and safety of grass sublingual immunotherapy tablet, MK-7243: a large randomized controlled trial. Ann Allergy Asthma Immunol 2014; 112 (2):146-53
Nerin N Bahceciler, et al. A milestone in house dust mite allergen immunotherapy: the new sublingual tablet S-524101 (actair) Expert review of vaccines. May 2016 At:16:46
Actair Product Information. Study 1: European multicenter, randomized controlled double-blind, placebo-controlled study conducted over 2 years with 509 patients with 300IR dose of Actair for 12 months and followed up subsequent treatment free year.