D1.217 - Reduction in healthcare resource utilization in pediatric patients treated with 300 IR liquid SLIT: a real‑world subanalysis from Spain and Italy

Sublingual immunotherapy (SLIT) is an effective, disease‑modifying treatment for pediatric respiratory allergies and may reduce healthcare costs by decreasing symptoms and healthcare resource utilization (HCRU). However, real‑world evidence specifically focused on children and adolescents remains limited, despite their high burden of allergic rhinitis (AR) and frequent comorbid asthma. This subanalysis aimed to evaluate direct AR‑related HCRU before and after 300 IR liquid SLIT in a pediatric population from Spain and Italy.

This retrospective observational study included patients aged 5–65 years with confirmed house dust mite (HDM) and/or pollen‑induced AR, with or without asthma, treated with 300 IR liquid SLIT for ≥6 months (HDM) or at least one pollen season (grass/tree pollens). The present subanalysis was restricted to pediatric patients (children 5–12 years, adolescents 13–17 years) treated in private allergy centers in Spain and Italy. Direct AR‑related HCRU was assessed as monthly per‑patient use of symptomatic medication (for AR and asthma) and number of visits (allergist, emergency department [ED], general practitioner [GP]) before and after SLIT. Comparisons were performed with McNemar’s test for categorical variables and paired t‑test or Wilcoxon Signed‑Rank test for continuous variables.

A total of 585 pediatric patients were analyzed, with a median age of 10.0 years (IQR 7.0–13.0); 63.8% were children and 36.2% adolescents, and 55.7% were male. SLIT was prescribed for pollen AR in 55.9% and HDM AR in 44.1% of patients; most had persistent (73.2%) and moderate (72.6%) rhinitis, and 30.9% had comorbid asthma. After at least one pollen season or ≥6 months of HDM SLIT, the proportion of pediatric patients using symptomatic medication was significantly reduced, with all comparisons achieving statistical significance except for oral corticosteroids (p=0.083). Monthly visits per patient decreased markedly: allergist visits from 0.6 to 0.3 (SD 0.59), GP visits from 0.5 to 0.1 (SD 0.51), and ED visits from 0.2 to 0.0 (SD 0.54), all statistically significant (Wilcoxon test, p<0.0001). These improvements in HCRU were consistent with those observed in the overall study population, underlining the robustness of the effect of 300 IR liquid SLIT in routine pediatric practice.

In this pediatric real‑world subanalysis from Spain and Italy, treatment with 300 IR liquid SLIT was associated with a clinically relevant and statistically significant reduction in symptomatic medication use and healthcare visits, including ED and GP consultations. These findings highlight the value of SLIT not only for symptom control but also for decreasing direct healthcare resource utilization in children and adolescents with allergic rhinitis, a population with high long‑term disease burden and substantial potential for early, cost‑saving intervention.