The German Institute for Quality and Efficiency in Health Care has assessed recent evidence on allergies. It found that the once controversial immune therapy against allergy symptoms can definitely help many people with allergies.
When it is green and the flowers have returned, the allergy season has hit its peak. And the number of people affected is still rising. At least 1 in 5 people in Germany get hayfever, and up to half of the population react at least sometimes to airborne allergens like pollen or house dust mites. But we still do not why allergies increased so much in recent decades. The Director of the Institute, Professor Peter Sawicki, said today that none of the theories about the increase in allergies has been proven. For example, childhood immunisation does not seem to be responsible for the growth of allergies.
"There are many unproven claims about allergies," said Professor Sawicki, "but there is also a growing body of research that has sifted out some facts from the myths. For example, expensive and time-consuming effort like removing all carpets from the house or washing bedlinen very frequently will be a waste for most people: it really is not possible to remove all the allergens from the house, no matter how hard you try. But there are things that can work, like specific immune therapy. And a range of drugs can reduce symptoms."
The Institute has reviewed the latest independent analyses of allergy research to find out which treatments or prevention measures could really work. Allergen immunotherapy can done by injections or sublingual ("under the tongue") drops, tablets or sprays. Both injections and sublingual treatments work. A report* shows that more than a dozen of these immunotherapy extracts are now amongst the 3,000 most prescribed medicines in Germany.
According to Professor Sawicki, "Sublingual therapy in particular is becoming very popular in Europe. Research has shown that it can reduce allergic symptoms in adults and it causes less adverse reactions than injections. We are still not completely certain if it is as effective as injections, or whether it works for children. But many more trials are being done and we expect good answers to these questions soon."
In Germany, the use of anti-histamines has dropped greatly in recent years. The Institute also examined the latest research on some of the biggest-selling anti-histamines. They can all relieve symptoms, but adverse effects are common with all of them. Some might provide relief more quickly than others, and some might have more adverse effects.
The Institute also looked at what might work to prevent allergies developing in children and came to several conclusions. If the parents quit smoking, this can help. Some infant formulas can occasionally cause some allergies. And there are early signs that pregnant women taking probiotics late in pregnancy might be able to help.
"Probiotics in pregnancy is an area of research the Institute will continue to monitor, to see whether trials establish whether or not this can really prevent allergies," according to Professor Sawicki.
The Institute's website, Informed Health Online, informs the public in plain language about evidence and medical developments that would interest those affected. The information is both English and German. The information released today reports on preventing allergies in children, specific immune therapy and some of the most commonly used anti-histamines. People who want to keep up with the latest publications on this independent publicly-funded website can subscribe to the free newsletter.
*Schwabe U, Paffrath D, Arzneiverordnungs-Report 2007. Heidelberg: Springer Medizin Verlag 2008.
Editor-in-Chief, Informed Health Online