allergic rhinitis; immunotherapy; mobile health; patient-reported outcomes; real-life data analysis
Abstract :
[en] BACKGROUND: Evidence regarding the effectiveness of allergen immunotherapy (AIT) on allergic rhinitis has been provided mostly by randomised controlled trials, with little data from real-life studies. OBJECTIVE: To compare the reported control of allergic rhinitis symptoms in three groups of users of the MASK-air(®) app: those receiving sublingual AIT (SLIT), those receiving subcutaneous AIT (SCIT), and those receiving no AIT. METHODS: We assessed the MASK-air(®) data of European users with self-reported grass pollen allergy, comparing the data reported by patients receiving SLIT, SCIT and no AIT. Outcome variables included the daily impact of allergy symptoms globally and on work (measured by visual analogue scales-VASs), and a combined symptom-medication score (CSMS). We applied Bayesian mixed-effects models, with clustering by patient, country and pollen season. RESULTS: We analysed a total of 42,756 days from 1,093 grass allergy patients, including 18,479 days of users under AIT. Compared to no AIT, SCIT was associated with similar VAS levels and CSMS. Compared to no AIT, SLIT-tablet was associated with lower values of VAS global allergy symptoms (average difference = 7.5 units out of 100; 95% credible interval [95%CrI] = -12.1;-2.8), lower VAS Work (average difference = 5.0; 95%CrI = -8.5;-1.5), and a lower CSMS (average difference = 3.7; 95%CrI = -9.3;2.2). When compared to SCIT, SLIT-tablet was associated with lower VAS global allergy symptoms (average difference = 10.2; 95%CrI = -17.2;-2.8), lower VAS Work (average difference = 7.8; 95%CrI = -15.1;0.2), and a lower CSMS (average difference = 9.3; 95%CrI = -18.5;0.2). CONCLUSION: In patients with grass pollen allergy, SLIT-tablet, when compared to no AIT and to SCIT, is associated with lower reported symptom severity. Future longitudinal studies following internationally-harmonised standards for performing and reporting real-world data in AIT are needed to better understand its 'real-world' effectiveness.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Sousa-Pinto, Bernardo ; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto
Azevedo, Luís Filipe; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto,
Sá-Sousa, Ana; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto,
Vieira, Rafael José; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto,
Amaral, Rita; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto,
Klimek, Ludger; Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, ; Center for Rhinology and Allergology, Wiesbaden, Germany.
Czarlewski, Wienczyslawa; Medical Consulting Czarlewski, Levallois, France. ; MASK-air, Montpellier, France.
Anto, Josep M; ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain. ; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. ; Universitat Pompeu Fabra (UPF), Barcelona, Spain. ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Bedbrook, Anna; MASK-air, Montpellier, France.
Kvedariene, Violeta; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, ; Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty
Ventura, Maria Teresa; University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari,
Ansotegui, Ignacio J; Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Bilbao,
Bergmann, Karl-Christian ; Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany. ; Corporate Member of Freie Universität Berlin, Berlin, Germany. ; Humboldt-Universität zu Berlin, Berlin, Germany.
Brussino, Luisa; Department of Medical Sciences, Allergy and Clinical Immunology Unit, University
Canonica, G Walter; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy. ; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center
Cardona, Victoria ; Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron &
Carreiro-Martins, Pedro; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar ; NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon,
Casale, Thomas; Division of Allergy/immunology, University of South Florida, Tampa, Florida, USA.
Cecchi, Lorenzo; SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
Chivato, Tomás; School of Medicine, University CEU San Pablo, Madrid, Spain.
Chu, Derek K; Department of Medicine and Health Research Methods, Evidence & Impact, McMaster
Cingi, Cemal; Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir,
Costa, Elisio M; UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy
Cruz, Alvaro A; Fundaçao ProAR, Federal University of Bahia, Salvador, Bahia, Brazil. ; GARD/WHO Planning Group, Salvador, Bahia, Brazil.
De Feo, Giulia; Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana',
Devillier, Philippe; VIM Suresnes, UMR_0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch,
Fokkens, Wytske J; Department of Otorhinolaryngology, Amsterdam University Medical Centres, location
Gaga, Mina; ERS President 2017-2018, Athens Chest Hospital, 7th Respiratory Medicine
Gemicioğlu, Bilun; Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa
Haahtela, Tari; Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki,
Ivancevich, Juan Carlos; Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
Ispayeva, Zhanat; Department of Allergology and Clinical Immunology of the Kazakh National Medical
Jutel, Marek; Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland. ; ALL-MED Medical Research Institute, Wroclaw, Poland.
Kuna, Piotr; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital,
Kaidashev, Igor; Poltava State Medical University, Poltava, Ukraine.
Kraxner, Helga; Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University,
Larenas-Linnemann, Désirée E; Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and
Laune, Daniel; KYomed INNOV, Montpellier, France.
Lipworth, Brian; Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine,
Louis, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pneumologie - allergologie ; GIGA I3 Research Group, Liege, Belgium.
Makris, Michaël; Allergy Unit 'D Kalogeromitros', 2nd Department of Dermatology and Venereology,
Monti, Riccardo; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico
Morais-Almeida, Mario; Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
Mösges, Ralph ; ClinCompetence Cologne GmbH, Cologne, Germany. ; IMSB, Medical Faculty, University of Cologne, Cologne, Germany.
Mullol, Joaquim; Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain. ; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University
Odemyr, Mikaëla; EFA European Federation of Allergy and Airways Diseases Patients' Associations,
Okamoto, Yoshitaka; Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
Papadopoulos, Nikolaos G; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
Patella, Vincenzo; Division of Allergy and Clinical Immunology, Department of Medicine, Agency of
Pham-Thi, Nhân; Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des
Regateiro, Frederico S; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto,
Reitsma, Sietze; Department of Otorhinolaryngology, Amsterdam University Medical Centres, location
Rouadi, Philip W; Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University ; ENT Department, Dar Al Shifa Hospital, Salmiya, Kuwait.
Samolinski, Boleslaw; Department of Prevention of Environmental Hazards, Allergology and Immunology,
Sova, Milan; Department of Pulmonary Medicine and Tuberculosis, University Hospital Brno,
Todo-Bom, Ana; MEDCIDS-Department of Community Medicine, Information and Health Decision
Taborda-Barata, Luis; Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal. ; UBIAir-Clinical & Experimental Lung Centre, University of Beira Interior, ; Department of Immunoallergology, Cova da Beira University Hospital Centre,
Tomazic, Peter Valentin; Department of General ORL, H&NS, Medical University of Graz, ENT-University
Toppila-Salmi, Sanna; Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki,
Sastre, Joaquin; Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of
Tsiligianni, Ioanna; Health Planning Unit, Department of Social Medicine, Faculty of Medicine, ; International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
Valiulis, Arunas; Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty
Wallace, Dana; Nova Southeastern University, Fort Lauderdale, Florida, USA.
Waserman, Susan; Department of Medicine, Clinical Immunology and Allergy, McMaster University,
Yorgancioglu, Arzu; Department of Pulmonology, Celal Bayar University, Manisa, Turkey.
Zidarn, Mihaela ; University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia. ; University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
Zuberbier, Torsten; Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany. ; Corporate Member of Freie Universität Berlin, Berlin, Germany. ; Humboldt-Universität zu Berlin, Berlin, Germany. ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP,
Fonseca, João Almeida; MEDCIDS-Department of Community Medicine, Information and Health Decision ; CINTESIS-Center for Health Technology and Services Research, University of Porto, ; Medicina, EDucação, I&D e Avaliação, Lda (MEDIDA), Porto, Portugal.
Bousquet, Jean ; Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany. ; Corporate Member of Freie Universität Berlin, Berlin, Germany. ; Humboldt-Universität zu Berlin, Berlin, Germany. ; University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia. ; University Hospital Montpellier, Montpellier, France.
Pfaar, Oliver ; Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology
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