What’s the Latest Research on Asthma and Allergies?
May is Asthma and Allergy Awareness Month. Today, more than 26 million Americans live with asthma – and every day, 10 Americans die from asthma. Worldwide, up to 30% of people have allergic rhinitis, or hay fever. Chances are, you or someone you know has allergies or asthma – you might even be suffering from seasonal or year-round allergies as you read this.
Fortunately for the millions of people living with allergies and asthma, new treatment options have become available to patients in recent years thanks to successful clinical trials, and more are in development. As researchers have learned more about asthma and allergies, treatment options have also become more personalized – underlining the need for diverse participation in clinical trials.
We chatted with Dr. Purvi Parikh, an allergist at NYU Langone and Asthma & Allergy Network spokesperson, about the latest available treatments in immunotherapy, targeted therapies for asthma, and promising treatments in development.
Antidote: I've been reading that targeted immunotherapy tablets have become more popular for treating some allergies. What kinds of patients are these right for?
Dr. Purvi Parikh: Immunotherapy in general is a great option for allergies and asthma, because even with all the best medications, all it's really doing is suppressing and managing the symptoms, but immunotherapy actually makes you less allergic over time. Some people are lucky in that they can even get close to almost a cure. Until now, we just had the injections, but now the FDA has approved different tablets for immunotherapy for grass pollen, ragweed pollen, and dust mites. For the right patient, those tablets can be very good. The one downside with the tablets is that with allergy shots, we can target multiple allergens at once, and most people aren't allergic to one thing. They're allergic to various pollens, or year-round allergens. Unfortunately, with the immunotherapy, each tablet has only been approved for individual use. For example, we can only desensitize you to grass, or to dust mites. Then there are certain patients that it's not ideal for. Also, if you have very uncontrolled asthma, it's not a good idea to do that tablet, because it can trigger a reaction. The ideal patient is the person who may have one allergen that's very severe for them, they travel a lot, they don't have other health problems. That's the ideal patient for the tablet: Someone with a busy schedule who can't come in for the shot.
Are more immunotherapy tablets in development in clinical trials?
They're currently studying the other pollens, such as tree pollen. They're looking at cat allergens, too.
What are some signs that you should consider a different treatment approach for your allergies?
If you notice your allergies are becoming more and more difficult to control with medication, it's not enough. Something that worked before may not work anymore if allergies become more severe. That's someone who I think should go on immunotherapy. Or, if you're developing new allergies, that's another sign you need a new treatment option. I have some people where it was only springtime that bothered them, but then they developed year-round allergies as well.
What advice do you have for patients with both spring allergies and asthma for controlling their symptoms?
The best thing is to start your medications early if you know that you're prone to having problems. If you know that spring is your worst time for symptoms, it's best to start end of March or even early April. It's much harder to get symptoms under control once things are full blown, rather than ahead of time.
Are there any allergy or asthma treatments in development that you're excited about?
For asthma specifically, there are a lot of new medications called biologics that target the part of your immune system that's triggering your asthma. A lot of people have allergic asthma but it's not the same from person to person. For some people, it might be driven by an antibody called IGE, which is an allergy antibody. It's nice because now we can really target the treatment for severe asthmatics, whereas before we were hoping one medication would work well for multiple people. It's exciting because it's a good way to get people off of steroids, which come with a lot of toxicities. These treatments target one particular part of the immune system, rather than suppressing everything like a steroid does.
What are your thoughts on patient involvement in clinical trials?
It's very important because that's the only way we can advance the field and get new medications approved. It's always a great idea to participate in these clinical trials because we need large numbers of participants, and we need people with all different types of symptoms. In medicine, no two people are exactly the same, so the more people we have participating, the more diversity we have, it helps everyone as a whole.
Do you ever have patients ask directly about getting involved in clinical trials?
I do, but I think it's up to the physician to let them know that these things exist. So it depends. Some people will ask, and some people don't know to ask. They don't know that's even an option. Then there's a group of people who are kind of suspicious or wary of them, because they don't want to be a "guinea pig" or in something experimental. There's a broad range. Some people are very much interested, some people don't know about it but then when you educate them they are interested, and then there's the group that's kind of hesitant.
Is there a kind of patient in particular that you'll typically refer to clinical trial opportunities?
It's usually those people who are having frequent exacerbations, they're getting sick often, they've failed treatment with other medications, those are the people I would definitely bring it up for. For some of these immunotherapy trials, if I see a patient who isn't able to come in for the shots, but would probably benefit from a tablet or something less frequent. and there's a study for that, I probably would recommend it to them. It varies from patient to patient based on what their illness is, and their lifestyle, and then what's required of the study.
It's very important to keep research going because that's the only way we'll be able to come out with new treatments that can help everybody. It's even important because now we're seeing allergies and asthma are not only increasing and on the rise, but they're getting more severe, too.
It sounds like the rise of personalized treatments is another reason we really need diverse participation in clinical trials.
I agree, because like we were saying before, for one person something that's very mild, can land another person I the hospital. It varies, so that's why it's even more important that those personalized treatments exist.
Find active asthma and allergy clinical trials looking for volunteers near you – start your search below.