Comparison of allergy immunotherapy medication persistence with a sublingual immunotherapy tablet versus subcutaneous immunotherapy in Germany

Allam, Jean‐Pierre; Andreasen, Jakob Nørgaard; Mette, Janina; Serup-Hansen, Niels; Wüstenberg, Eike

doi:10.1016/j.jaci.2017.12.999

Cited by 36 publications

(65 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the commonly high adherence in clinical trials does not mirror the daily behavior of patients in real life treatment but are the result from strict management follow-up according to study plans [2]. This is why we choose the well-established design approach based on GKV prescription data using the coverage data given in the SmPCs of the preparations as base for calculation of adherence [18,19,32]. Another aspect of uncertainty may originate from patients' varying drug intake compared to the original prescription not taking the drug as prescribed [33].…”

Section: K Original Articlementioning

confidence: 99%

House dust mite immunotherapy in Germany: real-world adherence to a subcutaneous allergoid and a sublingual tablet

Vogelberg

Brüggenjürgen

Richter³

et al. 2020

Allergo J Int

View full text Add to dashboard Cite

Summary Purpose Allergen immunotherapy (AIT) is the only disease-modifying treatment for allergic rhinitis (AR) and asthma (AA) with increasing efficacy observed during the recommended 3 years of treatment and the potential for medium and long-term benefits. Adherence is of utmost importance to achieve these goals in real life. The objective of this study was to evaluate real-world adherence to house dust mite (HDM) AIT with a subcutaneous (SCIT) allergoid preparation and a sublingual (SLIT) tablet. Patients and methods In this retrospective cohort analysis of a German longitudinal prescription database, patients receiving either a HDM-SCIT allergoid (n = 5677) or a HDM-SLIT tablet (n = 4720) were compared over a 3-year observation period. Study endpoints included adherence and days on therapy (DoT). Univariate statistical tests were used to assess the significance of the differences between SCIT vs. SLIT or the age classes. Results Based on the number of reimbursed prescriptions SCIT adherence was 55.0% after 3 years while SLIT adherence was remarkably lower with 30.3% (p < 0.0001). The difference was observed already after first and second year of treatment and was in favor of SCIT with 93.2% vs. 63.2% and 70.9% vs. 43.4%, respectively. After 3 years, days on therapy were significantly higher in the SCIT group with 824 days vs. 491 days (p < 0.0001) showing significantly better data for all age groups. Adherence to SCIT was the highest in children, followed by adolescents and adults while the adherence to SLIT was higher in adults than adolescents. Conclusion In this retrospective real-world cohort analysis in Germany, patients on subcutaneous AIT for HDM respiratory allergy achieved significantly higher adherence rates compared to the HDM-SLIT tablet over a 3-year treatment period. In addition, days on therapy were significantly higher for SCIT than for SLIT. It was shown that in real life significantly more patients receiving SCIT stay on the recommended treatment period of 3 years compared to SLIT subjects. This is important since effectiveness has been demonstrated to be linked with therapy duration.

show abstract

Section: K Original Articlementioning

confidence: 99%

House dust mite immunotherapy in Germany: real-world adherence to a subcutaneous allergoid and a sublingual tablet

Vogelberg

Brüggenjürgen

Richter³

et al. 2020

Allergo J Int

View full text Add to dashboard Cite

show abstract

“…We often find patients lack knowledge about AIT and there are numerous misconceptions about this therapy [25,31]. Furthermore, adherence to AIT is reportedly lower in realworld settings than in clinical trials [32][33][34], with lack of tolerability, cost, and perceived ineffectiveness being cited as possible factors for decreased adherence [35], so the provision of accurate information regarding adverse effects and when to expect an improvement in symptoms is very important.…”

Section: What Does the Evidence From Rwe Studies Of Ait Show?mentioning

confidence: 99%

Allergen immunotherapy: what is the added value of real-world evidence from retrospective claims database studies?

Devillier

Demoly

Molimard

2020

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

Introduction: Randomized controlled trials (RCTs) show that allergen immunotherapy (AIT) has proven long-term efficacy in patients with allergic rhinitis (AR). However, RCTs have limited generalizability and there is growing recognition that real-world evidence (RWE) is necessary to provide complementary data to those of RCTs, and corroborate their findings. Until recently, data from the real-world setting investigating the benefits of AIT for the treatment of patients with grass and birch pollen-associated AR were sparse, but new retrospective claims database studies from France and Germany have confirmed the sustained benefits of grass and birch pollen AIT in terms of significantly reduced progression of AR and asthma, and a significantly decreased risk of new-onset asthma. Areas covered: Here, we review the value of RWE used alongside data from traditional RCTs, and its potential strengths and limitations, and summarize the findings of the recent RWE studies investigating the benefits of AIT for the management of patients with grass and birch pollen-associated AR. Expert opinion: There is growing recognition of the necessity and value of RWE as a complement to data acquired in RCTs, to better understand the effects of AIT treatments in a broader, more representative patient population, and to help guide clinical decision-making.

show abstract

“…Of those who start AIT, a high percentage are non-adherent to the recommended treatment schedule, often discontinuing therapy before completion of the recommended 3 to 5 years needed to achieve sustained clinical benefit [36][37][38]. It is estimated that of the 24 million adults in the US with AR, 10 million are candidates for AIT, but only 3.5 million initiate AIT and up between 11% to 97% discontinue therapy before reaching 3 years of therapy [39][40][41][42][43][44][45][46][47].…”

Section: Adherence To Aitmentioning

confidence: 99%

“…The most meaningful studies are those that compare SCIT and SLIT head-to-head in the same research protocol. Nine studies, comparing persistence of SCIT to that of SLIT for a minimum of three years, published 2001-2018 were reviewed [39][40][41][42][43][44][45][46][47]. A total of 105,302 patients were included in these 9 studies [SCIT:96,297; SLIT8913:8913: Local nasal immunotherapy (LNIT), 82].…”

Section: Literature Review Of Persistence Of Aitmentioning

confidence: 99%

“…Unfortunately, only 3 of the 9 studies comparing SCIT and SLIT reviewed for persistence also reported on consistency [40,43,44], and these 3 studies all used different methods to determine consistency. Based upon a large German health disease database, of those who were persistent for 3 years, there was 83% and 81% consistency for SIT and SLIT, respectively, based upon the % of days for which prescribed doses were in the possession of the patients [40]. A Netherlands community pharmacy database study defined consistency as not being late for refilling any of the SLIT and SCIT treatment sets [43].…”

Section: Literature Review Of Persistence Of Aitmentioning

confidence: 99%

See 1 more Smart Citation

Allergen Immunotherapy: Efficacy, Persistence, Consistency, and Cost Effectiveness

Wallace

Уоллес²

2018

Vestn. Ross. univ. družby nar., Ser. Med.

View full text Add to dashboard Cite

Although allergen immunotherapy (AIT) has been used for the treatment of allergic rhinitis (AR), allergic conjunctivitis, asthma, stinging insect hypersensitivity, and atopic dermatitis for over 100 years, it has been slow to gain universal acceptance. With the publication of the "World Health Organization Position Paper, Allergen Immunotherapy" in 1998 which summarized the scientific evidence for the efficacy and long-term benefit of this therapy, it has become an accepted and respected modality of treatment. In this review there are discussed following topics of allergen immunotherapy: the reasons for recommending AIT, mechanism of action, subcutaneous and sublingual methods of application, duration, adherence and cost effectiveness. It is necessary to support, not blame, the patient for nonadherence as it is the responsibility of the patient, the physician, and the health-care system to create an environment in which the patient can be adherent. Nonadherence is multifactorial in most every patient and the physician must address all of the factors if adherence is to be improved. The greatest challenge is taking the time to create an individualized patient-tailored strategy to improve adherence, as one size does not fit all. Adherence is dynamic and selecting the best time to start AIT and assuring that there is close follow-up through AIT years of treatment is essential. The patient who is persistent and consistent in year one of AIT may not continue to be so in year three without added encouragement and support. The health-care systems and professional organizations need to help train physicians and their staff both in efficient and accurate ways to assess nonadherence and in implementing interventions to optimize adherence. The multidisciplinary approach to treating this disease of nonadherence will require the involvement of all healthcare professionals, researchers, professional organizations, insurance companies, and policy-makers.

show abstract

Comparison of allergy immunotherapy medication persistence with a sublingual immunotherapy tablet versus subcutaneous immunotherapy in Germany

Cited by 36 publications

References 8 publications

House dust mite immunotherapy in Germany: real-world adherence to a subcutaneous allergoid and a sublingual tablet

House dust mite immunotherapy in Germany: real-world adherence to a subcutaneous allergoid and a sublingual tablet

Allergen immunotherapy: what is the added value of real-world evidence from retrospective claims database studies?

Allergen Immunotherapy: Efficacy, Persistence, Consistency, and Cost Effectiveness

Contact Info

Product

Resources

About