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Medication persistence and adherence in allergy immunotherapy (AIT) has been reported to be lower in real life than in clinical studies, 1 with manufacturers' sales figures often indicating poorer adherence and persistence than postmarketing studies. 2,3 This might result from patients tending to be more compliant when their behavior is being recorded, which is commonly known as the Hawthorne effect. The low risk of anaphylaxis and serious adverse reactions with sublingual immunotherapy (SLIT) 4,5 has resulted in orodispersible SLIT-tablets being approved in Europe and the United States for self-administration provided that the first dose is tolerated under medical supervision. For many patients, self-administration of SLIT-tablets is an advantage over injection during subcutaneous immunotherapy (SCIT). However, dosing regimen and frequency of physician's office visits differ considerably between the 2 administration routes, and efficacy and safety profiles of individual products administered through each route vary widely. Because these factors have been reported to affect persistence and adherence, 6 we compared medication persistence and adherence with a SLIT-tablet versus SCIT products in patients with grass pollen allergy over a 3-year period from treatment initiation. This retrospective cohort study used prescription renewal rates for a 75,000 standardized quality units tablet (SQ-T), 2,800 BAU grass pollen SLIT-tablet, and 100 to 100,000 SQ-U/mL or 600 to 30,000 SQ1/mL suspension for subcutaneous injection from the German IMS Health Disease Analyzer database for the period of January 2006 to August 2014 to obtain an accurate picture of persistence and adherence in real life. More information about the products and database can be found in the Methods section in this article's

Background Allergic asthma causes substantial morbidity and constitutes a public health burden, which increases with asthma severity. There is evidence that allergy immunotherapy (AIT) prevents the progression of allergic rhinitis (AR) to asthma. However, evidence is missing on the potential of AIT to prevent progression from milder to more severe asthma. Methods This population‐based cohort study utilized healthcare data (2005 to 2014) from a statutory health insurance in Germany. The severity of asthma was classified according to the treatment steps recommended by the global initiative for asthma (GINA). The effect of AIT on the transition between the GINA steps was analyzed using multivariable Cox regression models adjusted for age and sex. Results From the total cohort of 1,739,440 patients, 39,167 individuals aged 14 years or older were classified as having incident asthma during the observation period and were included in the study. From these, 4111 patients (10.5%) received AIT. AIT exposure was associated with a significantly decreased likelihood of asthma progression from GINA step 1 to GINA step 3 (HR 0.87; 95% CI 0.80‐0.95) and GINA step 3 to GINA step 4 (HR 0.66; 95% CI 0.60‐0.74). GINA medication for step 2 and step 5 was rarely prescribed. Conclusions This observational study in a real‐world setting indicates that patients with allergic asthma who receive AIT are less likely to experience progression of asthma severity than asthma patients not receiving AIT.