Need for longitudinal studies to assess the real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma

Kamat, Siddhesh; Murdock, Dana; Xia, C.; Deshpande, Deepti

doi:10.1016/j.lanepe.2022.100382

Cited by 3 publications

(7 citation statements)

References 3 publications

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“…The last result is likely related to GBM AIT referrals and prescribing, and is compatible with the German REACTstudy finding that subjects treated with AIT were seen more frequently by specialists during the first 3-5 follow-up years, than non-treated in the prescription database. [3,15,17] Limitations A limitation of the study was the lack of data on clinical diagnosis of AR and sensitisation status. However, to identify those suffering from AR we restricted our analysis to individuals using INS, which is the classic common effective and specific medication prescribed for AR.…”

Section: Strengthsmentioning

confidence: 99%

“…In clinical trials, longer follow-up is restricted by resources and patient compliance, [11][12][13][14] whereas longitudinal observational studies are more feasible and can therefore add unique and valuable information about long term effects of AIT. [3,[6][7][8][9][10][15][16][17] Follow-up times up to 15 years after end of therapy have not been studied yet. Using prescription and register data since 1994 for the entire country of Denmark, we therefore studied effectiveness on AR medication use up to 15 years after end of 3 years treatment (18 years of follow-up) in a large, unselected, national patient population treated with GBM AIT, comparing with well-matched controls and also avoiding exclusions e.g.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of grass, birch, and mugwort pollen allergen immunotherapy over 18 years: A national cohort study in Denmark

Bager

Poulsen

Wohlfahrt

et al. 2022

Preprint

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Background Long-term effectiveness of pollen allergen immune therapy (AIT) for allergic rhinitis (AR) has been studied for different durations. We studied effectiveness over 18 years using nationwide register-data for Denmark. Methods A register-based cohort study using data on filled prescriptions, 1995-2018, Denmark. In a cohort of 1.1 million intranasal corticosteroid spray users (proxy for AR), we matched users treated with grass, birch or mugwort (GBM) AIT 1:2 with non-treated users on baseline year and 24 characteristics in the 3 years prior to baseline. The primary outcome was the odds ratio (OR) of using anti-allergic nasal spray during the pollen season in the treated vs. non-treated group modelled in a logistic generalized estimating equations analysis using an autoregressive correlation structure and adjusted for years since baseline (one year categories). Results Among 7,914 AR patients treated with GBM AIT, the OR of using nasal spray 0-5 years after baseline was reduced when compared with 15,520 non-treated AR individuals (0-2 years, odds ratio (OR) 0.81(0.76-0.85); 3-5 years, OR 0.82(0.77-0.87)), but was close to unity or higher thereafter (6-9 years, OR 0.96(0.91-1.03); 10-18 years, OR 1.15(1.06-1.24). In post-hoc analyses, results were more consistent for those who already had 3 of 3 baseline years of use (0-2 years, OR 0.59 (0.54-0.64); 3-5 years, OR 0.64 (0.59-0.71); 6-9 years, 0.82 (0.75-0.91); 10-18 years, 0.95 (0.84-1.08), and in patients using nasal spray in the last pollen season (0-2 years, OR 0.76 (0.72-0.80); 3-5 years 0.84 (0.78-0.91); 6-9 years, OR 0.94 (0.86-1.03); 10-18 years, 0.90 (0.81-1.00)) as opposed to patients who did not use nasal spray in the last pollen season. The post-hoc findings were likewise more consistent for eye drop and oral antihistamine users (secondary outcomes). Conclusion Patients treated with GBM AIT in routine care to a higher degree stopped using anti-allergic nasal spray 0-5 years after starting the standard three years of therapy. Post-hoc analyses suggested results were more consistent among patients with persistent AR.

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Section: Strengthsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effectiveness of grass, birch, and mugwort pollen allergen immunotherapy over 18 years: A national cohort study in Denmark

Bager

Poulsen

Wohlfahrt

et al. 2022

Preprint

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“…While Kamat et al. focus mainly on AR prescriptions, 4 the REACT-study also reported greater reductions in both reliever and controller asthma prescriptions, which are not available as OTC medications, and concurrently, clinically important outcomes like asthma exacerbations, diagnosis of pneumonia and hospitalisations all favoured the AIT group. 3 …”

mentioning

confidence: 95%

“…also speculate whether better access to specialist care could improve outcomes for AIT-treated subjects, since AIT is often administered by specialists. 4 The REACT-study did find that subjects treated with AIT were seen more frequently by specialists during the first 3–5 follow-up years. 3 While difference in access to care could lead to improved outcomes, it is also possible that the increased number of specialist visits would in fact disadvantage the AIT group.…”

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confidence: 98%

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Need for longitudinal studies to assess the real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma – Authors´ reply

Fritzsching¹,

Contoli

Porsbjerg

et al. 2022

The Lancet Regional Health - Europe

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The effectiveness of pollen allergen immunotherapy on allergic rhinitis over 18 years: A national cohort study in Denmark

Bager,

Poulsen,

Wohlfahrt

et al. 2024

Allergy

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BackgroundBecause long‐term effectiveness of pollen allergen immune therapy (AIT) for allergic rhinitis (AR) is not well‐described, we studied effectiveness over 18 years in Denmark.MethodsA register‐based cohort study using data on filled prescriptions, 1995–2016, Denmark. In a cohort of 1.1 million intranasal corticosteroid inhaler users (proxy for AR), we matched users treated with grass, birch or mugwort AIT 1:2 with non‐treated users on baseline year and 24 characteristics in the 3 years prior to baseline. The primary outcome was the odds ratio (OR) of using anti‐allergic nasal inhaler during the pollen season in the treated versus non‐treated group by years since baseline.ResultsAmong 7760 AR patients treated with pollen AIT, the OR of using nasal inhaler 0–5 years after baseline was reduced when compared with 15,520 non‐treated AR individuals (0–2 years, OR 0.84 (0.81–0.88); 3–5 years, OR 0.88 (0.84–0.92)), but was close to unity or higher thereafter (6–9 years, OR 1.03 (0.97–1.08); 10–18 years, OR 1.18 (1.11–1.26)). In post hoc analyses, results were more consistent for those who already had 3 of 3 baseline years of use, and in patients using nasal inhaler in the latest pollen season (0–2 years, OR 0.76 (0.72–0.79); 3–5 years OR 0.86 (0.81–0.93); 6–9 years, OR 0.94 (0.87–1.02); 10–18 years, OR 0.94 (0.86–1.04)) as opposed to no such use.ConclusionsPatients treated with pollen AIT in routine care to a higher degree stopped using anti‐allergic nasal inhaler 0–5 years after starting the standard 3 years of therapy, and not beyond 5 years. Post hoc analyses suggested effectiveness was more consistent among patients with persistent AR.

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Need for longitudinal studies to assess the real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma

Cited by 3 publications

References 3 publications

The effectiveness of grass, birch, and mugwort pollen allergen immunotherapy over 18 years: A national cohort study in Denmark

The effectiveness of grass, birch, and mugwort pollen allergen immunotherapy over 18 years: A national cohort study in Denmark

Need for longitudinal studies to assess the real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma – Authors´ reply

The effectiveness of pollen allergen immunotherapy on allergic rhinitis over 18 years: A national cohort study in Denmark

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