TY  - JOUR
A1  - Wahn, Ulrich
A1  - Bachert, Claus
A1  - Heinrich, Joachim
A1  - Richter, Hartmut
A1  - Zielen, Stefan
T1  - Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and asthma
T2  - Allergy
N2  - Background: Real‐world evidence is sparse on the benefits of allergen immunotherapy [AIT; subcutaneous/sublingual immunotherapy (SCIT/SLIT)], the only disease‐modifying intervention for allergic rhinitis (AR) with long‐term efficacy. This real‐life study evaluated the effect of six AITs (native pollen SLIT/SCIT, four allergoid SCITs) vs symptomatic medication use, on AR symptoms and asthma symptoms/onset, in patients with birch pollen‐associated AR and/or asthma.
Methods: In this retrospective cohort analysis of a German longitudinal prescription database, AIT patients received ≥2 successive seasonal treatment cycles; non‐AIT patients had ≥3 AR prescriptions in three seasons or previous month. Patients were matched for: index year, age, gender, main indication at index, number of seasonal cycles within treatment period, baseline AR/asthma treatment prescriptions. Multiple regression analysis compared prescription data in AIT and non‐AIT groups as proxy for clinical status/disease progression.
Results: Up to 6 years of follow‐up, significantly more AIT (65.4%) vs non‐AIT (47.4%) patients were AR medication‐free; odds ratio (OR) [95% confidence interval (CI)]: 0.51 [(0.48‐0.54); P < 0.001] (28.6% covariate‐adjusted reduction vs non‐AIT; P < 0.001), and significantly more AIT (49.1%) vs non‐AIT (35.1%) patients were asthma medication‐free [OR (95% CI): 0.59 (0.55‐0.65); P < 0.001] (32% reduction vs non‐AIT; P < 0.001), or reduced existing asthma medication use (32% covariate‐adjusted reduction vs non‐AIT; P < 0.001). During treatment, new‐onset asthma risk was significantly reduced in the AIT vs non‐AIT group (OR: 0.83; P = 0.001).
Conclusions: Birch pollen AIT demonstrated real‐world benefits up to 6 years post‐treatment cessation through significantly reduced AR and asthma medication intake, and significantly decreased risk of new‐onset asthma medication use on‐treatment.
KW  - allergic rhinitis
KW  - asthma
KW  - real-world evidence
KW  - subcutaneous immunotherapy
KW  - sublingual immunotherapy
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/54401
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-544016
SN  - 1398-9995
SN  - 0105-4538
N1  - This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction inany medium, provided the original work is properly cited and is not used for commercial purposes.
VL  - 74
SP  - 594
EP  - 604
PB  - Wiley
CY  - Oxford
ER  -