Department of Medicine, Section of Allergy, Asthma and Immunology, Penn State College of Medicine, Hershey, Pa.
Department of Medicine, Section of Allergy, Asthma and Immunology, Penn State College of Medicine, Hershey, Pa.
J Allergy Clin Immunol Pract. 2023 May;11(5):1528-1535.e2. doi: 10.1016/j.jaip.2023.01.034. Epub 2023 Feb 1.
Racial and ethnic differences exist in the severity of various atopic diseases including allergic rhinitis (AR). Patients of under-represented races and ethnicities may be subjected to disparate subcutaneous allergen immunotherapy (SCIT) prescription practices.
To explore the racial and ethnic disparities in the use of SCIT among patients with AR.
In this retrospective matched cohort study, we used the TriNetX US Collaborative Network, a multicenter electronic health record-based database to identify patients with AR 18 years and older. Patients were grouped according to their racial and ethnic identification. Study groups were matched for baseline demographics, atopic comorbidities, heart diseases and utilization of β-blockers, and angiotensin-converting enzyme inhibitors. The proportion of patients of under-represented racial and ethnic groups started on SCIT was contrasted to the non-Hispanic White cohort.
We identified 1,038,000 patients with AR; the mean age (±standard deviation) at the index was 49.7 (±16.1) years, and 64.6% were female. Ethnicity information was available from 87.3% of patients, and the majority (92.3%) were non-Hispanic. Over a 3-year observation period, fewer Black patients (relative risk [RR], 0.40; 95% confidence interval [CI], 0.33-0.48) and Hispanic patients (RR, 0.80; 95% CI, 0.64-0.99) were started on SCIT compared with non-Hispanic White patients. The proportions of Asian patients who were initiated on SCIT tended to be lower when compared with non-Hispanic White patients (RR, 0.69; 95% CI, 0.47-1.009).
In the United States, differences in SCIT prescription exist between Black and Hispanic patients relative to White patients. Barriers to treatment should be explored and mitigated.
各种特应性疾病（包括过敏性鼻炎 [AR]）的严重程度存在种族和民族差异。代表性不足的种族和族裔的患者可能会接受不同的皮下变应原免疫疗法（SCIT）处方实践。
探讨 AR 患者中 SCIT 使用的种族和民族差异。
在这项回顾性匹配队列研究中，我们使用了 TriNetX US 协作网络，这是一个基于多中心电子健康记录的数据库，以确定 18 岁及以上的 AR 患者。患者根据其种族和民族身份进行分组。研究组根据基线人口统计学、特应性合并症、心脏病和β受体阻滞剂以及血管紧张素转换酶抑制剂的使用情况进行匹配。与非西班牙裔白人队列相比，观察了代表性不足的种族和族裔群体中开始接受 SCIT 的患者的比例。
我们确定了 1038000 名 AR 患者；索引时的平均年龄（±标准差）为 49.7（±16.1）岁，64.6%为女性。87.3%的患者提供了种族信息，其中大多数（92.3%）是非西班牙裔。在 3 年的观察期内，与非西班牙裔白人患者相比，黑人患者（相对风险 [RR]，0.40；95%置信区间 [CI]，0.33-0.48）和西班牙裔患者（RR，0.80；95% CI，0.64-0.99）开始接受 SCIT 的人数较少。与非西班牙裔白人患者相比，亚洲患者开始接受 SCIT 的比例较低（RR，0.69；95% CI，0.47-1.009）。
在美国，与白人患者相比，黑人患者和西班牙裔患者在 SCIT 处方方面存在差异。应探讨和减轻治疗障碍。
