Tankersley Mike, Winders Tonya, Aagren Mark, Brandi Henrik, Hasse Pedersen Mikkel, Ledgaard Loftager Anne Sofie, Bøgelund Mette
Departments of Medicine, Pediatrics and Otolaryngology, University of Tennessee Health Science Center, Memphis, TN, USA.
The Tankersley Clinic, Memphis, TN, USA.
Patient Prefer Adherence. 2021 Nov 18;15:2539-2549. doi: 10.2147/PPA.S338337. eCollection 2021.
People with allergic rhinitis (AR) who are not controlled on conventional therapy can be treated using allergy immunotherapy (AIT) administered as tablets, injections or drops. In the US, the use of sublingual immunotherapy as tablets (SLIT-tablets) is limited in comparison to subcutaneous immunotherapy (SCIT).
This study investigated patients' preference for SLIT-tablets vs monthly or weekly SCIT from a US patient perspective.
We carried out a discrete choice experiment (DCE) consisting of two blocks with eight choice sets. Adults and caregivers of children with moderate-to-severe AR were included if they had not previously or were not currently receiving AIT. Three attributes were included in the design: the mode and frequency of administration, the risk of systemic reactions and the co-payment.
A total of 724 adults with AR and 665 caregivers of children with AR were included in the study. Both adults and caregivers had a significant preference for SLIT-tablets compared with both weekly and monthly injections and for less risk of anaphylactic shock. Caregivers were more risk-averse than adults when choosing their treatment, and the younger the child, the more risk-averse the caregiver. The preference for SLIT-tablets was found for both monoallergic and polyallergic adults and caregivers of monoallergic and polyallergic children. Respondents not wanting AIT for free were more risk-averse than those indicating that they wanted AIT for free.
Our findings suggest that SLIT-tablets is the preferred route of administration for AIT among adults and caregivers of children with AR.
常规治疗无法得到有效控制的过敏性鼻炎（AR）患者可采用片剂、注射剂或滴剂形式的变应原免疫疗法（AIT）进行治疗。在美国，与皮下免疫疗法（SCIT）相比，舌下免疫疗法片剂（SLIT-片剂）的使用较为有限。
本研究从美国患者的角度调查了患者对SLIT-片剂与每月或每周一次的SCIT的偏好。
我们进行了一项离散选择实验（DCE），该实验由两个模块和八个选择集组成。纳入此前未接受过或当前未接受AIT的中重度AR成人患者及其儿童护理人员。设计中纳入了三个属性：给药方式和频率、全身反应风险以及自付费用。
本研究共纳入724名AR成人患者和665名AR儿童护理人员。与每周和每月注射相比，成人患者和护理人员均明显更倾向于SLIT-片剂，且更倾向于过敏性休克风险较低的治疗方式。在选择治疗方法时，护理人员比成人患者更规避风险，孩子越小，护理人员越规避风险。单过敏原和多过敏原的成人患者以及单过敏原和多过敏原儿童的护理人员均表现出对SLIT-片剂的偏好。不希望免费接受AIT的受访者比表示希望免费接受AIT的受访者更规避风险。
我们的研究结果表明，对于AR成人患者及其儿童护理人员而言，SLIT-片剂是AIT的首选给药途径。
