Long-term real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma: Results from the REACT study, a retrospective cohort study.
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Long-term real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma : Results from the REACT study, a retrospective cohort study. / Fritzsching, Benedikt; Contoli, Marco; Porsbjerg, Celeste; Buchs, Sarah; Larsen, Julie Rask; Elliott, Lisa; Rodriguez, Mercedes Romano; Freemantle, Nick.
In: The Lancet Regional Health - Europe, Vol. 13, 100275, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Long-term real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma
T2 - Results from the REACT study, a retrospective cohort study.
AU - Fritzsching, Benedikt
AU - Contoli, Marco
AU - Porsbjerg, Celeste
AU - Buchs, Sarah
AU - Larsen, Julie Rask
AU - Elliott, Lisa
AU - Rodriguez, Mercedes Romano
AU - Freemantle, Nick
N1 - Publisher Copyright: © 2021 The Authors
PY - 2022
Y1 - 2022
N2 - 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 (P <0·0001). In addition to the reduction in asthma treatment in the AIT group, a greater reduction in severe asthma exacerbations was demonstrated (P<0·05). Reductions in pneumonia with antibiotic prescriptions, hospitalisations, and duration of inpatients stays were all in favour of AIT. 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.
AB - 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 (P <0·0001). In addition to the reduction in asthma treatment in the AIT group, a greater reduction in severe asthma exacerbations was demonstrated (P<0·05). Reductions in pneumonia with antibiotic prescriptions, hospitalisations, and duration of inpatients stays were all in favour of AIT. 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.
KW - Allergic rhinitis
KW - Allergy
KW - Allergy immunotherapy
KW - Asthma
KW - Effectiveness
KW - Real-world evidence
KW - Retrospective cohort study
U2 - 10.1016/j.lanepe.2021.100275
DO - 10.1016/j.lanepe.2021.100275
M3 - Journal article
C2 - 34901915
AN - SCOPUS:85120177384
VL - 13
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
SN - 2666-7762
M1 - 100275
ER -
ID: 314838830