Erlewyn-Lajeunesse Mich, Villa Luciano Perfetti, Shaikh Shifa, Smith Maria, Balodima Vasiliki, Baker Sarah, Dawson Tom, Ewan Pamela, Khan Sujoy, Marriage Deborah, Michaelis Louise, Ozygit Leyla Pur, Thursby-Pelham Anna, Warner Amena, Maslovskaya Olga
University of Southampton and Southampton Children's Hospital, Southampton, UK.
Department of Social Statistics and Demography, University of Southampton, Southampton, UK.
Clin Exp Allergy. 2025 Jun;55(6):458-468. doi: 10.1111/cea.70034. Epub 2025 Apr 1.
There is an unmet need for specialist allergy treatment in the United Kingdom. Allergen immunotherapy and treatment with omalizumab for chronic spontaneous urticaria (CSU) are key markers for these services. The British Society for Allergy and Clinical Immunology (BSACI) Registry for Immunotherapy (BRIT) is a national project to record the real-world effectiveness, safety and access to treatment for aero-allergen, venom and peanut immunotherapy as well as omalizumab for CSU.
We described participant demographics, the index of multiple deprivation (IMD) and access to treatment from the registry launch. Data for 1835 participants were available for analysis from 63 centres enrolled between 1st October 2018 and 24th August 2023.
96.5% (1771/1835) were living in England, with only 3.5% (64) being from the devolved nations. 14.4% (251/1748) were in the most affluent IMD decile compared to 4.5% (78/1748) in the most deprived IMD decile. White participants were 1.74 times more likely to be referred directly from primary care compared to people of Asian, black, mixed or other minority ethnic groups. Instead, these groups were referred more frequently from secondary or tertiary hospital services. The median distance travelled from home to the treatment centre was 15.2 miles, with evidence of clustering around specialist centres.
We have described disparities and unwarranted variation in the provision of treatment around the UK. The data suggest that there is limited access to immunotherapy in the devolved nations. Access is also reduced by socioeconomic deprivation. White participants were more likely to receive a direct referral from primary care than those from other ethnic groups whose referral pathways were more complex. Registry data are limited by participant enrolment and may have selection bias. Nevertheless, BRIT has highlighted inequity in access to specialist allergy services in the UK.
英国对专科过敏治疗存在未满足的需求。变应原免疫疗法和使用奥马珠单抗治疗慢性自发性荨麻疹（CSU）是这些服务的关键指标。英国过敏与临床免疫学会（BSACI）免疫疗法登记处（BRIT）是一个全国性项目，旨在记录空气变应原、毒液和花生免疫疗法以及奥马珠单抗治疗CSU的实际疗效、安全性和治疗可及性。
我们描述了参与者的人口统计学特征、多重贫困指数（IMD）以及自登记处启动以来的治疗可及性。2018年10月1日至2023年8月24日期间登记的63个中心有1835名参与者的数据可供分析。
96.5%（1771/1835）的参与者居住在英格兰，只有3.5%（64名）来自权力下放国家。14.4%（251/1748）处于IMD最富裕的十分位数，而处于IMD最贫困十分位数的为4.5%（78/1748）。与亚洲、黑人、混血或其他少数族裔群体相比，白人参与者从初级保健直接转诊的可能性高1.74倍。相反，这些群体从二级或三级医院服务转诊的频率更高。从家到治疗中心的中位距离为15.2英里，有证据表明在专科中心周围存在聚集现象。
我们描述了英国各地治疗提供方面的差异和不合理的变化。数据表明，权力下放国家的免疫疗法可及性有限。社会经济贫困也会降低可及性。白人参与者比其他族裔群体更有可能从初级保健直接获得转诊，而其他族裔群体的转诊途径更为复杂。登记处数据受参与者入组情况限制，可能存在选择偏倚。尽管如此，BRIT突出了英国专科过敏服务可及性方面的不平等。
