Pollen count: Looking for a long-term solution to hay fever? This could be it
Pollen is a perennial problem for many people in the UK. Every summer they must brace themselves for a season of itchy eyes and runny noses. For some, the reaction to plant powder can seem insufferable, impairing concentration at work and making it impossible to unwind on those summer evenings. While there are a wide-range of treatment options available, the stubborn nature of hay fever can mean symptoms persist despite people’s best efforts to beat it.
For people that have seemingly exhausted all options, immunotherapy might just do the trick.
According to research published in the journal JAMA, patients blighted by hay fever could markedly reduce symptoms for several years after a three-year course of treatment, but not after two years of treatment.
Previous research has shown that a type of immunotherapy that exposes patients to increasing amounts of grass pollen over time is an effective way to reduce severe symptoms in the long term.
But in the study scientists from Imperial College London have found that a two-year course of treatment is not enough to achieve lasting effects, bolstering previous findings that more time is needed taking the medication to get lasting benefit.
“You treat patients for three years and then they have a big improvement in their hay fever for several years afterwards,” said Professor Stephen Durham, Head of Allergy and Clinical Immunology at the National Heart and Lung Institute at Imperial and clinical lead for allergy services at Royal Brompton Hospital, who led the study.
“Exposing people to grass pollen in this way is a very effective treatment for people who really have debilitating hay fever.”
The worst culprit for hay fever tends to be grass pollen, which the body recognises as an invader, triggering an immune response.
A number of over the counter medications are available, such as nasal sprays and antihistamine tablets, but patients with more severe symptoms can be treated with immunotherapy, using a similar approach to the one trialled in children with peanut allergies.
By exposing their immune system to grass pollen extracts over time they are able to build up their resistance, either through injections or a pill containing pollen extract.
The study involved patient volunteers at Royal Brompton Hospital in London, which runs a world-class allergy clinic, researchers tested the effectiveness of two immunotherapies prescribed by the NHS which use grass pollen extract: an injection and a pill taken under the tongue.
After a two year course of treatment, the results showed that both therapies were effective at tackling symptoms, with patients reporting a dramatic improvement in their quality of life. However, one year after patients had stopped taking the medication the effects were no better than the placebo group.
“Hay fever causes major impairment of sleep, work and school performance and leisure activities during what for most of us is the best time of the year,” said Professor Durham.
Most people respond to the usual antihistamines and nasal sprays, although there is a portion who do not respond adequately or who have unacceptable side effects to the treatment.”
Two years of treatment was insufficient for long-term benefits.
Describing the current findings, Professor Durham said: “This study shows that whereas both immunotherapy treatments were highly effective, two years of treatment was insufficient for long-term benefits.
“Clinicians and patients should continue to follow international guidelines that recommend a minimum of three years’ treatment.”
Previous studies published by Imperial researchers have shown the long-lasting benefits of both immunotherapy injections and pills for severe hay fever – benefits which persist for at least two to three years after the treatment has stopped.
Professor Durham added: “We have reconfirmed that both treatments are effective but that in order to get the long-term clinical benefits after stopping the treatment, you have to take it for three years.”
As a first port of call, the NHS recommends taking the following steps to ease symptoms:
- Put Vaseline around your nostrils to trap pollen
- Wear wraparound sunglasses to stop pollen getting into your eyes
- Shower and change your clothes after you have been outside to wash pollen off
- Stay indoors whenever possible
- Keep windows and doors shut as much as possible
- Vacuum regularly and dust with a damp cloth
- Buy a pollen filter for the air vents in your car and a vacuum cleaner with a special HEPA filter
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