Treatments
When I opened Shepherd Allergy, I wanted to focus on helping my patients live their best lives. I believe that allergy care should be easy and accessible. The reason is obvious: people don’t like to do it if it’s not easy and accessible. Being a sufferer of asthma and non-allergic rhinitis myself, I also live this life and I understand the unique needs of patients who require this care. I want to provide personalized medicine to all of my patients with specific treatment plans, including immunotherapy or biologic treatments catered to their needs.
I partnered with Auni Allergy to offer my patients the newest and most innovative allergy treatments in the world. Its founder, Dr. Amber Patterson, is the first physician to do a clinical trial demonstrating the efficacy and safety of intralymphatic immunotherapy (ILIT) in the United States and the first to do a trial of ILIT in children in the world. I am proud to call her a longtime friend and mentor and I have eagerly followed her progress in the development of this company and its therapies. At our Huntington/Barboursville, WV location of Shepherd Allergy and Auni Allergy services, we will be providing ILIT and sublingual immunotherapy (SLIT) via Auni Allergy services.
Immunotherapy
For environmental allergic disease, immunotherapy is the term used when doctors administer allergens in small doses into the body in an attempt to teach it to recognize the allergens in a safe or normal, non-allergic way. This can be used to treat eye and skin allergies, as well as nasal and respiratory symptoms. While highly effective, this has historically been very time intensive and required multiple visits to the physician’s offices to safely receive appropriate dosing, often over the course of several years. For instance, a traditional course of “allergy shots”, or subcutaneous immunotherapy (SCIT) administered under the skin, received over a period of 5 years would take a minimum of 43 hours invested in being in observation at the allergist’s office, assuming there were no reactions to the shots and the patient was able to tolerate them without issue. This does not count driving to and from the appointment, nor waiting times nor actual administration of the injection. This leads to many more hours spent dedicated to receiving this medical treatment, and significant non-compliance with the treatment. However, there are alternatives to the traditional “allergy shot” that requires so much time investment and use of environmental resources.
Intralymphatic Immunotherapy (ILIT)
Intralymphatic immunotherapy, or ILIT, is a type of immunotherapy administered by an injection directly into a lymph node. The goal with this therapy is to deliver a larger quantity of relevant allergen directly to where it needs to go, into the lymph node, as opposed to doing the injection much further from the site of action and relying on immune cells to take small portions of the allergen to the lymph node after a subcutaneous injection. Doing direct delivery to the lymph node allows us to condense the allergy shot process into only three separate shots, given over a period of two months.
At Shepherd Allergy, the injection procedure is performed in a comfortable outpatient setting under ultrasound guidance. Each visit typically lasts less than one hour and patients are observed following the injection in a private waiting area. Multiple clinical trials have demonstrated a similar efficacy to traditional methods of immunotherapy. Most patients begin noticing improvement in their symptoms within a few months of completing the treatment experience. It has also been shown to have increased compliance, improved safety, and is considered virtually painless. Additionally, the much smaller amounts of allergen extract that are required also leads to less environmental impact and overall less medical waste.
Sublingual Immunotherapy (SLIT)
Sublingual immunotherapy, or SLIT, is another type of immunotherapy that is an alternative to traditional, time-consuming therapies. SLIT is administered by placing a drop of the prescribed allergen under the tongue once a day. After the first in-office observed dose, SLIT is administered by the patient, at home, in their familiar surroundings. Multiple clinical trials have demonstrated efficacy and improved safety compared to traditional immunotherapy methods. Patients generally notice symptom improvement building up gradually over the standard three years of treatment with this type of therapy.
Biologics
Biologics are medications that come from living sources or their products. They can be used to treat a variety of conditions, leading to highly individualized or personalized medical treatment.
Dr. Shepherd is knowledgeable about multiple different types of biologics used to treat allergic disease as well as primary immunodeficiency.
Currently, there are many FDA-approved biological therapies for different allergic diseases. The list includes treatments for the following:
Asthma
Atopic dermatitis or eczema
Chronic rhinosinusitis with nasal polyposis (chronic sinus disease with nasal polyps)
Eosinophilic esophagitis
Chronic urticaria and angioedema (chronic hives and swelling)
There are also various biologic therapies available for primary immunodeficiency. Immunoglobulin replacement can be given for many conditions and Dr. Shepherd has extensive experience with intravenous immunoglobulin (IVIG), subcutaneous immunoglobulin (SCIG), and hyaluronidase-facilitated subcutaneous immune globulin (fSCIG) in both adults and children.
Hereditary angioedema is another disease resulting from missing or malfunctioning parts of the immune system. There are many different biologic treatments available including as-needed therapy and preventative therapies. Dr. Shepherd can help you choose what is right for you or your child. Now treating patients in the Huntington and Barboursville areas of West Virginia, as well as surrounding Tristate regions of southern Ohio and eastern Kentucky.