Jutel Marek, Brüggenjürgen Bernd, Richter Hartmut, Vogelberg Christian
All-MED Medical Research Institute, Wrocław, Poland.
Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland.
Allergy. 2020 Aug;75(8):2050-2058. doi: 10.1111/all.14240. Epub 2020 Mar 12.
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.
本研究的目的是基于近期实际数据，分析变应原类毒素的变应原免疫疗法（AIT）治疗屋尘螨（HDM）诱发的变应性鼻炎和/或哮喘的有效性。以哮喘发病率和相应药物的消耗量作为持续症状的指标来衡量治疗结果。
在对德国纵向处方数据库进行的这项回顾性队列分析中，将在两个连续不同季节周期中接受至少两张相关螨AIT处方的患者与在连续螨季节中接受至少三张症状性变应性鼻炎（AR）处方的非AIT患者进行比较。研究终点包括AR进展、哮喘进展、哮喘发生和治疗依从性。我们使用多变量回归分析来估计AIT的效果，并对相关变量进行调整。
本研究纳入了2350例接受螨类变应原类毒素治疗的患者和64740例对照患者。经过长达6年的随访，接受螨类变应原类毒素治疗的患者所需的AR和哮喘处方明显少于对照组（59.7%对10.8%），哮喘发生的概率也显著更低。接受类毒素治疗的患者在第二年年底的依从率为63.8%，在第三年年底为38.6%。
这一真实世界的证据证实了皮下注射HDM螨类变应原类毒素的AIT在治疗变应性鼻炎和/或哮喘方面具有良好疗效。长达6年的随访通过测量AR药物数量并证明哮喘药物显著减少，揭示了AIT在变应性鼻炎方面的显著效果。
