Real-world evidence of subcutaneous allergoid immunotherapy in house dust mite-induced allergic rhinitis and asthma.
allergic rhinitis
asthma
house dust mites
real-world evidence
subcutaneous immunotherapy
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
09
08
2019
revised:
15
01
2020
accepted:
22
01
2020
pubmed:
23
2
2020
medline:
15
5
2021
entrez:
22
2
2020
Statut:
ppublish
Résumé
The objective of this study was to analyze the effectiveness of allergen immunotherapy (AIT) with an allergoid in the treatment of house dust mites (HDM)-induced allergic rhinitis and/or asthma based on recent real-life data. The outcomes were measured using asthma incidence and consumption of corresponding medications as the indicator of persisting symptoms. In this retrospective cohort analysis of a German longitudinal prescription database, patients who received at least two relevant mite AIT prescriptions in two different successive seasonal cycles were compared with non-AIT patients who received at least three symptomatic allergic rhinitis (AR) prescriptions in successive mite seasons. Study endpoints included AR progression, asthma progression, asthma occurrence, and therapy adherence. We used multivariate regression analyses to estimate the effects of AIT, adjusting for relevant variables. This study included 2350 patients receiving a mite allergoid and 64 740 control patients. After up to 6 years of follow-up, patients treated with mite allergoid required significantly fewer AR and asthma prescriptions (59.7% vs 10.8%) than the control group, and the probability of asthma development was significantly lower. The adherence of patients receiving allergoid was 63.8% at the end of the second year and 38.6% at the end of the third year. This real-world evidence confirms the good efficacy of subcutaneous AIT with HDM mite allergoid in the treatment of allergic rhinitis and/or asthma. Up to 6 years of follow-up revealed significant effects in allergic rhinitis by measuring the number of AR medications and demonstrating significant reductions in asthma medications.
Sections du résumé
BACKGROUND
The objective of this study was to analyze the effectiveness of allergen immunotherapy (AIT) with an allergoid in the treatment of house dust mites (HDM)-induced allergic rhinitis and/or asthma based on recent real-life data. The outcomes were measured using asthma incidence and consumption of corresponding medications as the indicator of persisting symptoms.
METHODS
In this retrospective cohort analysis of a German longitudinal prescription database, patients who received at least two relevant mite AIT prescriptions in two different successive seasonal cycles were compared with non-AIT patients who received at least three symptomatic allergic rhinitis (AR) prescriptions in successive mite seasons. Study endpoints included AR progression, asthma progression, asthma occurrence, and therapy adherence. We used multivariate regression analyses to estimate the effects of AIT, adjusting for relevant variables.
RESULTS
This study included 2350 patients receiving a mite allergoid and 64 740 control patients. After up to 6 years of follow-up, patients treated with mite allergoid required significantly fewer AR and asthma prescriptions (59.7% vs 10.8%) than the control group, and the probability of asthma development was significantly lower. The adherence of patients receiving allergoid was 63.8% at the end of the second year and 38.6% at the end of the third year.
CONCLUSIONS
This real-world evidence confirms the good efficacy of subcutaneous AIT with HDM mite allergoid in the treatment of allergic rhinitis and/or asthma. Up to 6 years of follow-up revealed significant effects in allergic rhinitis by measuring the number of AR medications and demonstrating significant reductions in asthma medications.
Substances chimiques
Allergoids
0
Dust
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2050-2058Informations de copyright
© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Références
Nathan RA. The burden of allergic rhinitis. Allergy Asthma Proc. 2007;28(1):3-9.
Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004;24(5):758-764.
Calderon MA, Demoly P, Casale T, et al. Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies: an AIRWAYS integrated care pathways (ICPs) programme item (Action Plan B3 of the European innovation partnership on active and healthy ageing) and the global alliance against chronic respiratory diseases (GARD), a world health organization GARD research demonstration project. Clin Transl Allergy. 2016;6:41.
Gough H, Grabenhenrich L, Reich A, et al. Allergic multimorbidity of asthma, rhinitis and eczema over 20 years in the German birth cohort MAS. Pediatr Allergy Immunol. 2015;26(5):431-437.
Huang FL, Liao EC, Yu SJ. House dust mite allergy: its innate immune response and immunotherapy. Immunobiology. 2018;223(3):300-302.
Bousquet PJ, Chinn S, Janson C, et al. Geographical variation in the prevalence of positive skin tests to environmental aeroallergens in the European Community Respiratory Health Survey I. Allergy. 2007;62(3):301-309.
Lodge CJ, Lowe AJ, Gurrin LC, et al. House dust mite sensitization in toddlers predicts current wheeze at age 12 years. J Allergy Clin Immunol. 2011;128(4):782-788.
Colloff MJ. Dust Mites. Dordrecht, the Netherlands: Springer, CSIRO Publishing; 2009.
Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the world health organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8-160.
Brozek JL, Bousquet J, Baena-Cagnani CE, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466-476.
Frew A, Schnitker J, Kettner J, Doemer C, Cromwell O, Narkus A. Specific immunotherapy with house dust mites allergoid is safe and clinically efficacious. Allergy Clin Immunol Int. 2005;(1 Suppl):527.
Hafner D, Reich K, Matricardi PM, Meyer H, Kettner J, Narkus A. Prospective validation of 'Allergy-Control-SCORE(TM)': a novel symptom-medication score for clinical trials. Allergy. 2011;66(5):629-636.
Dokic D, Schnitker J, Narkus A, Cromwell O, Frank E. Clinical effects of specific immunotherapy: a two-year double-blind, placebo-controlled study with a one year follow-up. Prilozi. 2005;26(2):113-129.
Bonertz A, Roberts GC, Hoefnagel M, et al. Challenges in the implementation of EAACI guidelines on allergen immunotherapy: a global perspective on the regulation of allergen products. Allergy. 2018;73(1):64-76.
Jutel M, Rudert M, Kreimendahl F, Kuna P. Efficacy and tolerability of a house dust mite allergoid in allergic bronchial asthma: a randomized dose-ranging trial. Immunotherapy. 2018;10(13):1149-1161.
Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol. 2010;126(5):942-949.
Rosewich M, Arendt S, El Moussaoui S, Schulze J, Schubert R, Zielen S. Bronchial allergen provocation: a useful method to assess the efficacy of specific immunotherapy in children. Pediatr Allergy Immunol. 2013;24(5):434-440.
Hartmann D, Fischl A, Herrmann E, Schulze J, Schubert R, Zielen S. Prospective comparison of a nonmodified and a modified mite extract for immunotherapy in children and adolescents. Immunotherapy. 2019;11(12):1015-1029.
Garrison LP Jr, Neumann PJ, Erickson P, Marshall D, Mullins CD. Using real-world data for coverage and payment decisions: the ISPOR real-world data task force report. Value Health. 2007;10(5):326-335.
Wahn U, Bachert C, Heinrich J, Richter H, Zielen S. Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and asthma. Allergy. 2019;74(3):594-604.
Devillier P, Wahn U, Zielen S, Heinrich J. Grass pollen sublingual immunotherapy tablets provide long-term relief of grass pollen-associated allergic rhinitis and reduce the risk of asthma: findings from a retrospective, real-world database subanalysis. Expert Rev Clin Immunol. 2017;13(12):1199-1206.
Zielen S, Devillier P, Heinrich J, Richter H, Wahn U. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy. 2018;73(1):165-177.
Brehler R, Kahlert H, Thum-Oltmer S. Hypoallergene präparate in der SCIT. Allergo J Int. 2010;19:8.
Augustin M, Scheibe C, Cossé A, Eichhorn T, Fischer F, Willers C. Vom Allergenextrakt zum Allergenprodukt: Aufklärung des Milbenallergenspektrums. Allergo J Int. 2019;28:1.
Richter H, Dombrowski S, Hamer H, Hadji P, Kostev K. Use of a German longitudinal prescription database (LRx) in pharmacoepidemiology. Ger Med Sci. 2015;13:7.
Migueres M, Dávila I, Frati F, et al. Types of sensitization to aeroallergens: definitions, prevalences and impact on the diagnosis and treatment of allergic respiratory disease. Clin Transl Allergy. 2014;4(1):16.
Wahn U, Calderon MA, Demoly P. Real-life clinical practice and management of polysensitized patients with respiratory allergies: a large, global survey of clinicians prescribing allergen immunotherapy. Expert Rev Clin Immunol. 2017;13(3):283-289.
Garcia-Robaina JC, Sanchez I, de la Torre F, Fernandez-Caldas E, Casanovas M. Successful management of mite-allergic asthma with modified extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae in a double-blind, placebo-controlled study. J Allergy Clin Immunol. 2006;118(5):1026-1032.
Demoly P, Emminger W, Rehm D, Backer V, Tommerup L, Kleine-Tebbe J. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol. 2016;137(2):444-451.
Arasi S, Corsello G, Villani A, Pajno GB. The future outlook on allergen immunotherapy in children: 2018 and beyond. Ital J Pediatr. 2018;44(1):80.
Nelson HS. Update on house dust mite immunotherapy: are more studies needed? Curr Opin Allergy Clin Immunol. 2014;14(6):542-548.
Mahajan R. Real world data: additional source for making clinical decisions. Int J Appl Basic Med Res. 2015;5(2):82.
Frieden TR. Evidence for health decision making - beyond randomized controlled trials. N Engl J Med. 2017;377(5):465-475.
Camm AJ, Fox KAA. Strengths and weaknesses of ‘real-world’ studies involving non-vitamin K antagonist oral anticoagulants. Open Heart. 2018;5(1).
Berger ML, Mamdani M, Atkins D, Johnson ML. Good research practices for comparative effectiveness research: defining, reporting and interpreting nonrandomized studies of treatment effects using secondary data sources: the ISPOR good research practices for retrospective database analysis task force report-part I. Value Health. 2009;12(8):1044-1052.
Ciprandi G, Natoli V, Puccinelli P, Incorvaia C, Italian Cometa Study G. Allergic rhinitis: the eligible candidate to mite immunotherapy in the real world. Allergy Asthma Clin Immunol. 2017;13:11.
Manzotti G, Riario-Sforza GG, Dimatteo M, Scolari C, Makri E, Incorvaia C. Comparing the compliance to a short schedule of subcutaneous immunotherapy and to sublingual immunotherapy during three years of treatment. Eur Ann Allergy Clin Immunol. 2016;48(6):224-227.
Ariano R, Berto P, Tracci D, Incorvaia C, Frati F. Pharmacoeconomics of allergen immunotherapy compared with symptomatic drug treatment in patients with allergic rhinitis and asthma. Allergy Asthma Proc. 2006;27(2):159-163.
Lu Y, Xu L, Xia M, Li Y, Cao L. The efficacy and safety of subcutaneous immunotherapy in mite-sensitized subjects with asthma: a meta-analysis. Respir Care. 2015;60(2):269.
Virchow JC, Backer V, Kuna P, et al. Efficacy of a house dust mite sublingual allergen immunotherapy tablet in adults with allergic asthma: a randomized clinical trial. JAMA. 2016;315(16):1715-1725.
Jacobsen L, Niggemann B, Dreborg S, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. 2007;62(8):943-948.
Senna G, Caminati M, Lockey RF. Allergen immunotherapy adherence in the real world: how bad is it and how can it be improved? Curr Treat Options Allergy. 2015;2:14.
Incorvaia C, Mauro M, Leo G, Ridolo E. Adherence to sublingual immunotherapy. Curr Allergy Asthma Rep. 2016;16(2):12.
Senna G, Ridolo E, Calderon M, Lombardi C, Canonica GW, Passalacqua G. Evidence of adherence to allergen-specific immunotherapy. Curr Opin Allergy Clin Immunol. 2009;9(6):544-548.
Cavkaytar O, Akdis CA, Akdis M. Modulation of immune responses by immunotherapy in allergic diseases. Curr Opin Pharmacol. 2014;17:30-37.
Senna G, Crivellaro MA, Bonadonna P, Dama AR, Schiappoli M, Passalaqua. Optimal dosing of allergen immunotherapy: efficacy, safety, long-lasting effect. Eur Ann Allergy Clin Immunol. 2003;35(10):386-392.
Schmitt J, Schwarz K, Stadler E, Wustenberg EG. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: results from a large retrospective cohort study. J Allergy Clin Immunol. 2015;136(6):1511-1516.
Bruggenjurgen B, Reinhold T. Cost-effectiveness of grass pollen subcutaneous immunotherapy (SCIT) compared to sublingual immunotherapy (SLIT) and symptomatic treatment in Austria, Spain, and Switzerland. J Med Econ. 2018;21(4):374-381.
Novak N, Buhl T, Oliver PO. Adherence during early allergen immunotherapy and strategies to motivate and support patients. Eur Med J. 2018;3(3):9.
Wallace D. Allergen immunotherapy: efficacy, persistence, consistency, and cost effectiveness. RUDN J Med. 2018;22(3):14.
Kelly HW, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med. 2012;367(10):904-912.
Reinhold T, Ostermann J, Thum-Oltmer S, Bruggenjurgen B. Influence of subcutaneous specific immunotherapy on drug costs in children suffering from allergic asthma. Clin Transl Allergy. 2013;3(1):30.
Himmel W, Hummers-Pradier E, Schümann H, Kochen MM. The predictive value of asthma medications to identify individuals with asthma-a study in German general practices. Br J Gen Pract. 2001;51(472):879.