From the Allergy Partners of San Diego, San Diego, California,.
ALK-Abelló, Hørsholm, Denmark; and.
Allergy Asthma Proc. 2021 Jan 1;42(1):55-64. doi: 10.2500/aap.2021.42.200114. Epub 2020 Dec 23.
There is a dearth of real-world evidence studies focused on allergy immunotherapy (AIT) use among patients with allergic rhinitis (AR). This study examined claims data of AR patients residing in the United States to assess patient characteristics and health outcomes. AR patients were identified in the IBM MarketScan database between January 1, 2014, and March 31, 2017. Patients receiving AIT were identified with relevant billing codes (earliest AIT claim for vaccine as the index date); patients without AIT were identified with claims that contained a diagnosis code for AR (earliest AR claim as the index date). All the patients were required to have continuous enrollment 12 months prior to and following their index date. AIT patients reaching 25+ injection claims were analyzed as a separate maintenance cohort. Patients were assessed for demographic characteristics, comorbid conditions, and health care utilization. A total of 2,334,530 AR patients were included; 103,207 had at least one AIT claim, with 45,279 (43.9%) of these patients reaching maintenance. Patients who reached AIT maintenance presented higher rates of baseline comorbidities than both the full AIT cohort and the patients with no AIT claims, including asthma (34.6% versus 30.1% versus 7.5%) and upper respiratory tract infections (63.1% versus 60.3% versus 34.2%). From baseline to follow-up, maintenance AIT patients demonstrated reductions in all AR-related comorbidities assessed, along with reductions in all-cause and AR-related service utilization. Patients initiating AIT presented the greatest need for therapeutic intervention, as evidenced by higher allergy-related comorbidities; those who reached maintenance demonstrated improved outcomes following the initiation of therapy. Continued efforts to increase patient awareness and adherence to AIT are needed.
针对变应性鼻炎（AR）患者接受过敏免疫疗法（AIT）的真实世界证据研究较为匮乏。本研究通过分析美国 AR 患者的理赔数据，评估了患者的特征和健康结局。于 2014 年 1 月 1 日至 2017 年 3 月 31 日期间，在 IBM MarketScan 数据库中确定 AR 患者。采用相关计费代码（最早的疫苗 AIT 理赔记录作为索引日期）确定接受 AIT 的患者；采用包含 AR 诊断代码的理赔记录（最早的 AR 理赔记录作为索引日期）确定未接受 AIT 的患者。所有患者均需在索引日期前和后连续 12 个月参保。对达到 25+注射理赔记录的 AIT 患者进行了单独的维持队列分析。评估了患者的人口统计学特征、合并症和医疗保健利用情况。共纳入 2334530 名 AR 患者；其中 103207 名患者至少有一次 AIT 理赔记录，其中 45279 名（43.9%）患者达到维持治疗。达到 AIT 维持治疗的患者与整个 AIT 队列和无 AIT 理赔记录的患者相比，基线合并症发生率更高，包括哮喘（34.6%比 30.1%比 7.5%）和上呼吸道感染（63.1%比 60.3%比 34.2%）。从基线到随访，维持 AIT 患者评估的所有 AR 相关合并症均有所减少，全因和 AR 相关服务利用率也有所降低。启动 AIT 的患者需要进行治疗干预的需求最大，这反映在更高的过敏相关合并症上；达到维持治疗的患者在开始治疗后表现出了更好的结局。需要继续努力提高患者对 AIT 的认识和依从性。
