Immunotherapy is the practice of administering gradually increasing doses of an allergen extract (eg pollen) in order to reduce the symptoms of hayfever or asthma that it causes. It was first carried out almost 100 years ago and is now in widespread use around the world. It is sometimes referred to as ‘allergy vaccination’ or ‘desensitisation’. Until recently, immunotherapy involved having a series of injections (subcutaneous immunotherapy) over a period of three to five years. Injections needed to be given in hospital and close observation was required for an hour after each ‘shot’, because of a small risk of a severe allergic reaction.

 

SLIT entails the placing of drops (Stalorol product) or tablets (Grazax product) - under the tongue. This method is very safe and means that injections are not needed. However, it needs to be taken on a daily basis. Therapy is initiated in clinic but then continues at home. The medication is kept under the tongue for at least 1 minute before swallowing. Children are generally only able to comply with this demand from around 6 years of age (it is both frustrating - and expensive - if children refuse the medications).   The most common side effects were itchiness and swelling in the mouth after taking the medicine. This can be helped by taking antihistamines beforehand, or if the symptoms are recurrent, reducing the dose. Side effects are very rarely troublesome enough for the patient to stop the treatment.

 

The tree pollen SLIT product is made up of Betulaceae pollens. Betulaceeae, or the Birch Family, includes six genera of deciduous nut-bearing trees and shrubs, including Birches, Alders, Hazels, Hornbeams...  

We offer SCIT to Grass and Tree Pollen using Pollinex Quattro; this entails 4 injections, one week apart, repeated over 3 years. This may be a better mode of administration for those who are unlikely to comply with a daily medication and who will tolerate the injections.  4 appointments, every 7 days, are however required for the administration and supervision of the shots. If needed local anaesthetic creams can be provided for application at home prior to attending the clinic for shots.

 

 

Pollen Therapy is best if initiated in the winter months (when pollen counts are low), the other therapies (e.g. house dust mite) can be commenced at any time during the year.We invoice you for the SLIT product; upon receipt of payment we will order your SLIT therapy (this cost is seldom covered by medical insurance), and secure an appointment. Bookings are now being taken for pollen SLIT initiation in Oct 2009.

 

Please contact the Practice Manager for details re the costs involved; these are equivalent for all products offered.  Allow at least 2 weeks for the product to be delivered after payment.  The practice will need to book convenient appointments for you.  Linda Irwin administers and directs the Immunotherapy program under the supervision of Dr Du Toit. Therapy will only intiate when the products have been paid for.

 

(If on Stalorol drops) -  two appointments are required. At the first appointment we initiate the low-dose therapy. Therapy then continues, at the same dose, at home on a daily basis, for 7-10 days. At the second appointment, we supervise the administration of the higher dose (maintenance therapy). This then continues at home until all medication is completed, the treatment is repeated every 3 years. This product is used 'off license' in the UK

  

(If on ALK's Grazax) - only one initiation appointment is required; therapy then continues, as a daily tablet under the tongue, for 3 continuous years (with annual review). In the UK, this product is licensed for grass pollen induced rhinitis and/or conjunctivitis for children (5 years or older). Grazax contains 75.000 SQ-T per tablet of Timothy Grass pollen. Excipients include Gelatin (fish source), this has not proved to be a problem for fish allergic patients but caution will be practices in this regard.

 

If on Pollinex Quattro; this entails 4 injections, one week apart. This is repeated over 3 years. This is the best mode of administration for those who are unlikely to comply with a daily medication e.g. many teenagers, and who will tolerate the injections. The grass and tree pollens can be mixed and given in the same injection or given in each arm separately. This will only be given at the Westminster Bridge Consulting Rooms. This product is currently used 'off license' in the UK. The older version of this product is licensed in the UK, but this entails 6 injections ie many clinic visits. This product contains multiple Grass Pollens.