Sublingual immunotherapy with customized allergy drops in routine practice France: Which patients and for what reasons?

Study objective. - To clarify the circumstances and reasons for prescribing allergens prepared specifically for an individual [named-patient products (NPPs)] when initiating allergen immunotherapy (AIT) in real world conditions in mainland France.Patients and methods. - An observational cross-sectional study conducted by 92 allergy specialists who were asked to complete a registry entry for all patients consulting consecutively for a first AIT prescription during two periods (autumn and spring) between September 2021 and June 2022. Doctors were asked to provide information on treatment methods and reasons for the prescription in patients having received at least one NPP and who were included in the cohort.Results. - Among the 3410 patients in the registry (children [26%], adolescents [17%], adults [57%]), 99% were prescribed AIT for rhinitis and/or conjunctivitis (72%), and/or associated asthma (39%); 68% were prescribed an NPP exclusively (children [87%], adolescents [12%], adults [63%]). Among the 1111 patients in the cohort (children [36%], adolescents [12%], adults [52%]), 73% were poly-sensitised, 44% had asthma, and at least 24% had another allergic co-morbidity. The main reasons for choosing NPPs were flexibility of dosage (35%), unavailability of the tablet form (24%) and indication not available (17%). In patients eligible for the tablet, the remaining cost to be paid by the patient was the reason for the prescription in 22% of cases. Conclusion. - While allergen tablets remain the preferred choice given the far greater knowledge of their efficacy and tolerance, in clinical practice NPPs continue to play an important role in the treatment of respiratory allergies in France. (c) 2023 Societe franc, aise d'allergologie. Published by Elsevier Masson SAS. All rights reserved.