If you, like 20% of the UK, suffer from hay fever, you’ll likely know the pain of spending the summer months with itchy or watery eyes, a cough or runny rose. If you're a severe hay fever sufferer, then you'll also likely know it can go beyond annoying and actually, really start to affect the quality of your life.
Some people are able to use antihistamines or nasal sprays for relief, while others have such bad symptoms that nothing seems to help (we see you!) and given that we're currently experiencing a super high pollen count, those people may be interested to learn about the Kenalog injection: a jab which promises to manage severe hay fever symptoms. Though it's no longer available on the NHS, suffers can still access the shot through private clinics, at up to £100 a pop.
Kenalog (anyone else think it sounds like a type of cereal, btw?) contains a steroid called triamcinolone acetonide, which is injected into a large muscle in the body. Once injected, says Abbas Kanani, Superintendent Pharmacist at Chemist Click, "it slowly distributes from the muscle for three to eight weeks, and travels through the body, offering relief from hay fever symptoms." He also explains that it's only advisable to have a maximum of two injections in one season, too.
Whether or not you’re eligible for the injection depends on the severity of your symptoms, however, Kanani adds. For example, your symptoms must be affecting your quality of life or exacerbating other medical conditions, such as asthma or Chronic Obstructive Pulmonary Disorder. This is something you need to discuss with a trained medical professional, such as your GP, beforehand.
"Pregnant women can have the injection, but again, this should be discussed with your GP prior to administration," he notes.
Are there any risks to the Kenalog injection?
As with pretty much anything health-related, there are pros and cons to weigh up. "We need to assess whether the benefits outweigh the risks involved, taking into consideration the effect that severe hay fever has on quality of life," explains Kanani. "Unlike tablets, which can be stopped if side effects are experienced, you are unable to withdraw the effects of the injection once it has been administered."
And here's the big clincher: the steroid used in Kenalog temporarily suppresses the immune system - stopping the symptoms of hay fever in the process (it suppresses the body’s immune response to histamines) - which could admittedly be a problem during a global pandemic.
Dr James Cave, a GP and editor of the Drugs And Therapeutic Bulletin, is sceptical for these reasons. "For three weeks after having the injection your immune system is suppressed, which means you are seriously at risk of infections like chicken pox and measles,’ he previously told BBC Radio 4's Inside Health programme. "Likewise if you have a serious illness or a road traffic accident, you may not be able to cope with the stress, with Kenalog suppressing your own stress reactions."
Dr James also notes that the injection used to be available on the NHS but was discontinued as it was "too toxic".
Mild side effects can include headaches, joint pain and low mood, along with breathlessness, an irregular heartbeat and bone pain. As a result of this, the injection should only be made available to those who have exhausted all other treatment options such as nasal sprays, eye drops and antihistamines. The 50mg or 100mg doses are 10 or 20 times stronger than the oral steroid tablets now offered on the NHS.
Does the Kenalog injection really work?
In spite of its potential cons, there's scientific evidence that the Kenalog hay fever injection is effective, which could make it a tempting choice for some. According to the NHS, in 1999, a Drug and Therapeutics Bulletin (DTB) concluded that "a single dose is likely to relieve hay fever symptoms but it is unclear for how long any benefit is likely to last, what unwanted effects might develop and how it compares with standard therapy".
In 2019, UK Medicines Information conducted another review and noted: "Despite the likelihood that a single injection of Kenalog will relieve hay fever symptoms, there remains uncertainly about the efficacy and safety of repeated administration.
"There is a paucity of comparative studies and no new data on Kenalog have been published to change the conclusions of the DTB review in 1999 that this product should not be used."
While no one can deny the appeal of stopping hay fever with a singular injection (and compared to taking tablets every day, it could be pretty convenient), the risks definitely need to be taken into account. Ultimately, it's a personal decision for you - and a doctor - to make together.
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