Oral drops can give kids needle-free relief from asthma, allergies

May 06, 2013

Allergy shots are commonly used to treat children with severe environmental allergies and asthma, but under-the-tongue drops may offer yet another beneficial -- and stick-free -- option for pediatric allergy sufferers, according to a Johns Hopkins Children's Center review of existing scientific evidence.

The new research comes on the heels of another recent Hopkins study, which showed that oral drops provide a safe and effective alternative for adult allergy sufferers.

The new review, appearing May 6 in the journal Pediatrics, is an analysis of 34 previously published clinical trials and suggests that both drops and injections work well in alleviating the bothersome symptoms of allergic rhinitis and asthma, the research team says. In addition to being better tolerated by needle-averse children, the oral treatment can be given at home, sparing the family a visit to the doctor's office.

"Our findings suggest the needle-free approach is a reasonable way to provide much-needed relief to millions of children who suffer from asthma or seasonal allergies," says lead author Julia Kim, M.D., M.P.H., a pediatric research fellow at Johns Hopkins Children's Center.

Allergy shots, which contain tiny amounts of proteins found in environmental allergens such as dust mites and pollen, are a standard treatment for severe seasonal allergies in children who do not get relief from medication. However, under-the-tongue drops are not approved for use by the U.S. Food and Drug Administration and are only offered off label by some physicians. The needle-free approach is widely available in Europe, where patients are commonly treated with sublingual pills and drops, the researchers say.

The new findings, Kim notes, are encouraging enough to prompt a second look at oral drops as a treatment option.

The Hopkins researchers first looked at 13 studies that involved 920 children and compared the efficacy of allergy injections to either placebo or standard allergy medication. Overall, the researchers found that injections provide better symptom relief than placebo and standard medication for children with asthma or allergic rhinitis. The team next analyzed 18 trials involving 1,580 children treated with oral-drop therapy, placebo or standard medication for asthma and rhinitis or either condition alone. In this group, the researchers also found that oral drops provided superior relief of asthma symptoms, compared with patients who got the placebo and/or standard drugs. Oral drops also provided better symptom relief than placebo and standard medication in children with allergic rhinitis or rhino-conjunctivitis, a condition marked by runny nose and itchy, red and swollen eyes.

Only three of the 34 studies in the review directly compared shots and drops and, the investigators say, more head-to-head comparisons may shed better light on the comparative effectiveness of the two treatments. However, the researchers add, the results of the 31 remaining studies they looked at indicate both oral drops and allergy shots can successfully rid children of coughing, sneezing, runny noses, itchy eyes and wheezing.

The three studies that directly compared injections versus oral drops for symptom relief of dust mite-induced asthma and rhinitis showed no strong evidence that children given shots fared better than children who got oral drops, Kim said.

Both treatments, overall, caused relatively mild side effects, such as itching of the mouth, skin rashes or wheezing. A single severe reaction was reported following an injection.

More than 6 million children in the United States suffer from asthma, while allergic rhinitis affects 40 percent of American kids.
-end-
The research was funded by the U.S. Agency for Healthcare Research and Quality under grant number HHSA 290-2007-10061.

Co-investigators on the study were Sandra Lin, M.D.; Catalina Suarez-Cuervo, M.D.; Yohalakshmi Chelladurai, M.B.B.S., M.P.H.; Murugappan Ramanathan, M.D.; Jodi Segal, M.D., M.P.H.; and Nkiruka Erekosima, M.D., M.P.H., all of Johns Hopkins.

Related on the Web:
Hate Allergy Shots? Oral Allergy Drops are a Pretty Good Option for Some Allergy and Allergic Asthma Sufferers, Study Review Shows

Johns Hopkins Medicine

Related Asthma Articles from Brightsurf:

Breastfeeding and risks of allergies and asthma
In an Acta Paediatrica study, exclusive breastfeeding for the first 3 months was linked with a lower risk of respiratory allergies and asthma when children reached 6 years of age.

Researchers make asthma breakthrough
Researchers from Trinity College Dublin have made a breakthrough that may eventually lead to improved therapeutic options for people living with asthma.

Physics vs. asthma
A research team from the MIPT Center for Molecular Mechanisms of Aging and Age-Related Diseases has collaborated with colleagues from the U.S., Canada, France, and Germany to determine the spatial structure of the CysLT1 receptor.

New knowledge on the development of asthma
Researchers at Karolinska Institutet in Sweden have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways.

Eating fish may help prevent asthma
A scientist from James Cook University in Australia says an innovative study has revealed new evidence that eating fish can help prevent asthma.

Academic performance of urban children with asthma worse than peers without asthma
A new study published in Annals of Allergy, Asthma and Immunology shows urban children with poorly controlled asthma, particularly those who are ethnic minorities, also suffer academically.

Asthma Controller Step Down Yardstick -- treatment guidance for when asthma improves
The focus for asthma treatment is often stepping up treatment, but clinicians need to know how to step down therapy when symptoms improve.

Asthma management tools improve asthma control and reduce hospital visits
A set of comprehensive asthma management tools helps decrease asthma-related visits to the emergency department, urgent care or hospital and improves patients' asthma control.

Asthma linked to infertility but not among women taking regular asthma preventers
Women with asthma who only use short-acting asthma relievers take longer to become pregnant than other women, according to research published in the European Respiratory Journal.

What are the best ways to diagnose and manage asthma?
A team of experts from The University of Texas Medical Branch at Galveston examined the current information available from many different sources on diagnosing and managing mild to moderate asthma in adults and summarized them.

Read More: Asthma News and Asthma Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.