真实世界中抗蛇毒免疫治疗和肾上腺素自动注射器的使用情况。

Real-Life Adherence to Venom Immunotherapy and Adrenaline Autoinjector.

机构信息

Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark.

Institute of Clinical Research, Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, University of Southern Denmark, Odense, Denmark.

出版信息

Int Arch Allergy Immunol. 2024;185(3):228-236. doi: 10.1159/000535294. Epub 2023 Dec 5.

DOI:10.1159/000535294

PMID:38052182

Abstract

INTRODUCTION

Venom immunotherapy (VIT) and adrenaline autoinjector (AAI) are important therapies in venom anaphylaxis. Adherence to VIT and AAI in patients with venom allergy has been evaluated in a few studies; however, solid data are lacking. This study aimed to evaluate VIT and AAI retrieval rates in patients with venom allergy with a special focus on adherence to treatment. Adherence was compared to subcutaneous immunotherapy (SCIT) with inhalant allergens.

METHODS

This was a retrospective study among patients registered for allergen immunotherapy at the Allergy Center, Odense University Hospital, Denmark, from January 1, 2010, to December 31, 2014. Data on purchased immunotherapy and AAI were obtained from the Danish National Health Service Prescription Database. Multivariable logistic regression was used to analyze if allergen, age, sex, mastocytosis, and treatment site affected adherence.

RESULTS

The 3-year adherence to VIT was 92.4% (244/264) compared to 87.4% (215/246) in SCIT with inhalant allergens, and the 5-year adherence to VIT was 84.1% (222/264) compared to 74.8% (184/246) in SCIT with inhalant allergens (p = 0.045). Females treated with VIT were more adherent than males (p = 0.45 [3-year], p = 0.008 [5-year]), whereas allergen, age, mastocytosis, or treatment site did not significantly affect adherence. Only 28.6% of patients (12/42) purchased an AAI after premature termination of VIT.

CONCLUSION

In this register-based study, we found that the 3- and 5-year adherences to VIT and SCIT with inhalant allergens are at the upper end of the spectrum hitherto reported. Patients' 5-year adherence to VIT was higher than patients' 5-year adherence to SCIT with inhalant allergens. If VIT was prematurely terminated, less than 1/3 would have purchased an AAI.

摘要

简介

毒液免疫疗法（VIT）和肾上腺素自动注射器（AAI）是毒液过敏反应的重要治疗方法。已有少数研究评估了毒液过敏患者对 VIT 和 AAI 的依从性，但缺乏确凿的数据。本研究旨在评估对毒液过敏患者的 VIT 和 AAI 检索率，并特别关注治疗的依从性。将依从性与皮下免疫疗法（SCIT）进行比较。

方法

这是一项回顾性研究，研究对象为 2010 年 1 月 1 日至 2014 年 12 月 31 日期间在丹麦奥胡斯大学医院过敏中心注册接受过敏原免疫治疗的患者。从丹麦国家卫生服务处方数据库中获取购买免疫治疗和 AAI 的数据。采用多变量逻辑回归分析过敏原、年龄、性别、肥大细胞增多症和治疗部位是否影响依从性。

结果

VIT 的 3 年依从率为 92.4%（244/264），而 SCIT 与吸入性过敏原的 3 年依从率为 87.4%（215/246），VIT 的 5 年依从率为 84.1%（222/264），而 SCIT 与吸入性过敏原的 5 年依从率为 74.8%（184/246）（p=0.045）。接受 VIT 治疗的女性比男性更依从（p=0.45[3 年]，p=0.008[5 年]），而过敏原、年龄、肥大细胞增多症或治疗部位对依从性没有显著影响。仅 28.6%（12/42）的患者在 VIT 提前终止后购买了 AAI。