Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and asthma
- 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.
Author: | Ulrich Wahn, Claus Bachert, Joachim Heinrich, Hartmut Richter, Stefan ZielenORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-544016 |
DOI: | https://doi.org/10.1111/all.13598 |
ISSN: | 1398-9995 |
ISSN: | 0105-4538 |
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/30183091 |
Parent Title (German): | Allergy |
Publisher: | Wiley |
Place of publication: | Oxford |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2018/09/05 |
Date of first Publication: | 2018/09/05 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2020/05/12 |
Tag: | allergic rhinitis; asthma; real-world evidence; subcutaneous immunotherapy; sublingual immunotherapy |
Volume: | 74 |
Page Number: | 11 |
First Page: | 594 |
Last Page: | 604 |
Note: | 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. |
HeBIS-PPN: | 46591943X |
Institutes: | Medizin / Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (English): | Creative Commons - Namensnennung-Nicht kommerziell 4.0 |