Long-term real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma: Results from the REACT study, a retrospective cohort study.

BACKGROUND

Allergen immunotherapy (AIT) is the only causal treatment for respiratory allergy. Long-term real-life effectiveness of AIT remains to be demonstrated beyond the evidence from randomised controlled trials (RCTs).

METHODS

REACT (Real world effectiveness in allergy immunotherapy) is a retrospective cohort study using claims data between 2007 and 2017. Study eligibility was a confirmed diagnosis of allergic rhinitis (AR), with or without asthma, and AIT. To ensure comparable groups, AIT-treated subjects were propensity score matched 1:1 with control subjects, using characteristic and potential confounding variables. Outcomes were analysed as within (pre vs post AIT) and between (AIT vs control) group differences across 9 years of follow-up (ClinicalTrial.gov: NCT04125888).

FINDINGS

46,024 AIT-treated subjects were matched with control subjects and 14,614 were included in the pre-existing asthma cohort. AIT-treated subjects were 29·5 (16·3) years and 53% were male. Compared to pre-index year, AIT was consistently associated with greater reductions compared to control subjects in AR and asthma prescriptions, including both asthma controller and reliever prescriptions. Additionally, the AIT group had significantly greater likelihood of stepping down asthma treatment (

INTERPRETATION

The study extends the existing RCT evidence for AIT by demonstrating longer-term and sustained effectiveness of AIT in the real world. Additionally, in patients with concurrent asthma, AIT was associated with reduced likelihood of asthma exacerbations and pneumonia.

FUNDING

The study was funded by ALK A/S.

Informations de copyright

© 2021 The Authors.

Déclaration de conflit d'intérêts

Dr. Fritzsching reports personal fees (pertaining travelling to study meeting) from ALK during the conduct of the study; and speaker honorarium from Novartis and from Merck Sharp & Dohme, outside the submitted work. Dr. Contoli reports personal fees from Alk-Abello, during the conduct of the study; grants, personal fees and non-financial support from Chiesi, personal fees and non-financial support from AstraZeneca, personal fees and non-financial support from Boehringer Ingelheim, grants, personal fees and non-financial support from GlaxoSmithKline, personal fees and non-financial support from Novartis, personal fees and non-financial support from Zambon, grants from University of Ferrara - Italy, outside the submitted work. Dr. Porsbjerg reports grants from ALK, grants and personal fees from Astra Zeneca, grants and personal fees from GSK, grants and personal fees from Novartis, grants, and personal fees from Chiesi, grants and personal fees from Sanofi, grants and personal fees from TEVA, outside the submitted work. Sarah Buchs reports to be employed at ALK-Abello. Dr. Rask Larsen reports being an employee at ALK. Dr. Elliott has nothing to disclose. Ms. Romano Rodriguez reports she is an ALK employee. Dr. Freemantle reports personal fees from Astrazeneca, personal fees from Ipsen, personal fees from Sanofi Aventis, personal fees from Grifols, personal fees from Novatis, personal fees from Aimmune, personal fees from Vertex, personal fees from MSD, personal fees from Allergan, outside the submitted work.