The hay fever season has started again. According to Dr. Hanneke Oude Elberink, internist – allergist at UMC Groningen, 1 in 5 people in the Netherlands suffers from hay fever. A large proportion of these people use hay fever medicines. But there is something else to combat hay fever, namely immunotherapy. Oude Elberink tells more about this.
“Fatigue is one of the most common symptoms of hay fever,” said Dr. Old Elberink. “In addition, many hay fever patients suffer from sneezing, itchy and burning eyes, a runny nose and nasal congestion during the season, which further increases fatigue. Some of the people develop asthmatic complaints. They suffer from shortness of breath, wheezing and reduced exercise tolerance.”
What to do against hay fever?
“Immunotherapy with allergens is a therapy that will teach your immune system that it does not have to react allergically. An allergen is a substance that you can be allergic to. In hay fever these are pollen. Immunotherapy with allergens is the oldest form of immunotherapy in existence and has been used since the beginning of the last century. In the past, this was only possible by injecting the allergen into the arm with a prick, nowadays treatment with melting tablets is also an option in a number of cases.”
Immunotherapy with melting tablets
“The injection form starts with a build-up phase. In that phase you will receive weekly injections with increasing amounts of the allergen. After 7 to 13 weeks, the maintenance dose is reached and you switch to monthly injections.
With immunotherapy with melting tablets, someone comes to us on the first day to take the tablet to see if there is no allergic reaction. If not, this tablet should then be taken daily. To really make a change in the immune system, you have to keep up the immunotherapy for 3 to 5 years. This therapy triggers the immune system and shows that pollen is a normal substance to which the body does not have to react allergically.”
Treatment succeeds in 1 in 3
“If the treatment is successful, you have made a lasting change in the immune system. In general, in 1 in 3 people the treatment is completely successful. In 1 in 3 people the treatment has an effect and the hay fever is less severe and they can reduce with medication. Unfortunately, in the remaining group, the treatment is not effective.
Incidentally, the success rate at our UMCG is higher, probably because we look much more critically at whether the treatment will be useful for someone. We continue to monitor the patient closely after the start of treatment, especially because it is important that they remain faithful to the therapy to increase the chance of success.”
“The immunotherapy can also help with allergic reactions to house dust mites, insects and cats. It also sometimes happens that this treatment is used in people who have an allergic reaction to a certain drug. Unfortunately, with a drug allergy, the effect is never permanent, but we can temporarily prevent someone from having an allergic reaction, so that we can give the drug.”
Treatment known to few
This treatment is by no means known to everyone. “Sound evidence about the effectiveness of this therapy could not be provided for years. Subsequently, many new medicines have been developed over the years for the treatment of allergic complaints. These drugs often work very well, reducing the need for immunotherapy. However, these drugs help as long as they are taken. Once you stop, it doesn’t help anymore. Today there are a lot of studies showing the effectiveness of immunotherapy.”
Health insurer often takes care of costs
In general, this treatment is fully reimbursed by the health insurer. “Be careful with the basic health insurance policies, they do not always reimburse the treatment,” says Dr. Old Elberink
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