Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and asthma

被引:109
作者
Wahn, Ulrich [1 ]
Bachert, Claus [2 ]
Heinrich, Joachim [3 ]
Richter, Hartmut [4 ]
Zielen, Stefan [5 ]
机构
[1] Charite, Dept Paediat Pneumol & Immunol, Berlin, Germany
[2] Univ Ghent, Upper Airways Res Lab, Ghent, Belgium
[3] German Res Ctr Environm Hlth GmbH, Helmholtz Zentrum Munich, Inst Epidemiol, Neuherberg, Germany
[4] IQVIA Commercial GmbH & Co OHG, Frankfurt, Germany
[5] Goethe Univ Hosp, Dept Paediat, Div Allergol Pulmonol & Cyst Fibrosis, Frankfurt, Germany
关键词
allergic rhinitis; asthma; real-world evidence; subcutaneous immunotherapy; sublingual immunotherapy; INTERNATIONAL CONSENSUS; RISK-FACTORS; DIAGNOSIS; VACCINES; ADULTS; HEALTH;
D O I
10.1111/all.13598
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
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.
引用
收藏
页码:594 / 604
页数:11
相关论文
共 33 条
[1]  
[Anonymous], 2015, GLOB ATL ALL RHIN CH
[2]  
[Anonymous], 2008, CHMPEWP185042006
[3]   Risk factors of new-onset asthma in adults: a population-based international cohort study [J].
Anto, J. M. ;
Sunyer, J. ;
Basagana, X. ;
Garcia-Esteban, R. ;
Cerveri, I. ;
de Marco, R. ;
Heinrich, J. ;
Janson, C. ;
Jarvis, D. ;
Kogevinas, M. ;
Kuenzli, N. ;
Leynaert, B. ;
Svanes, C. ;
Wjst, M. ;
Gislason, T. ;
Burney, P. .
ALLERGY, 2010, 65 (08) :1021-1030
[4]   Prevalence and rate of diagnosis of allergic rhinitis in Europe [J].
Bauchau, V ;
Durham, SR .
EUROPEAN RESPIRATORY JOURNAL, 2004, 24 (05) :758-764
[5]   A survey of the burden of allergic rhinitis in Europe [J].
Canonica, G. W. ;
Bousquet, J. ;
Mullol, J. ;
Scadding, G. K. ;
Virchow, J. C. .
ALLERGY, 2007, 62 :17-25
[6]   Allergen Immunotherapy (AIT): a prototype of Precision Medicine [J].
Canonica, G. W. ;
Bachert, C. ;
Hellings, P. ;
Ryan, D. ;
Valovirta, E. ;
Wickman, M. ;
De Beaumont, O. ;
Bousquet, J. .
WORLD ALLERGY ORGANIZATION JOURNAL, 2015, 8
[7]   Sublingual immunotherapy: World Allergy Organization position paper 2013 update [J].
Canonica, Giorgio Walter ;
Cox, Linda ;
Pawankar, Ruby ;
Baena-Cagnani, Carlos E. ;
Blaiss, Michael ;
Bonini, Sergio ;
Bousquet, Jean ;
Calderon, Moises ;
Compalati, Enrico ;
Durham, Stephen R. ;
van Wijk, Roy Gerth ;
Larenas-Linnemann, Desiree ;
Nelson, Harold ;
Passalacqua, Giovanni ;
Pfaar, Oliver ;
Rosario, Nelson ;
Ryan, Dermot ;
Rosenwasser, Lanny ;
Schmid-Grendelmeier, Peter ;
Senna, Gianenrico ;
Valovirta, Erkka ;
Van Bever, Hugo ;
Vichyanond, Pakit ;
Wahn, Ulrich ;
Yusuf, Osman .
WORLD ALLERGY ORGANIZATION JOURNAL, 2014, 7
[8]   Safety of immunotherapy with therapeutic vaccines containing depigmented and polymerized allergen extracts [J].
Casanovas, M. ;
Martin, R. ;
Jimenez, C. ;
Caballero, R. ;
Fernandez-Caldas, E. .
CLINICAL AND EXPERIMENTAL ALLERGY, 2007, 37 (03) :434-440
[9]   Comparative study of tolerance between unmodified and high doses of chemically modified allergen vaccines of Dermatophagoides pteronyssinus [J].
Casanovas, M ;
Fernández-Caldas, E ;
Alamar, R ;
Basomba, A .
INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY, 2005, 137 (03) :211-218
[10]   From IgE to clinical trials of allergic rhinitis [J].
Ciprandi, Giorgio ;
Marseglia, Gian Luigi ;
Castagnoli, Riccardo ;
Valsecchi, Chiara ;
Tagliacarne, Carlotta ;
Caimmi, Silvia .
EXPERT REVIEW OF CLINICAL IMMUNOLOGY, 2015, 11 (12) :1321-1333