D3.187 - Sustained Clinical Benefit of Allergen Immunotherapy in Allergic Rhinitis: A Real-Life Study

Introduction

Allergen immunotherapy (AIT) is the only causal treatment for IgE-mediated allergic diseases and therefore has the potential for a long-term benefit lasting for years after its discontinuation. However, real-life evidence on the effect of this treatment is still needed.

The aim

To evaluate the long-term effect of AIT on the severity of allergic rhinitis (AR) in real-life conditions using two assessment methods.

Patients with AR who had completed a three-year course of sublingual (SLIT) or subcutaneous (SCIT) AIT- two or more years after treatment discontinuation were included. The severity of AR was assessed using the Combined Symptom and Medication Score (CSMS) and a paper-based Visual Analog Scale (VAS).

A total of 153 patients were included, 101 men (66.01%), aged 18–62 years (mean age 34 years). Patients completed AIT as follows: up to 4 years ago – 37 patients; 5–7 years – 60 patients; more than 8 years – 56 patients. According to the type of AIT, 64 patients (41.83%) were treated for house dust mite (HDM) allergy (36 [56.25%] with SLIT) and 89 patients (58.17%) for grass pollen allergy (81 [91.30%] with SLIT).

The CSMS according to the time since completion of AIT was 1.12 (SD 1.01), 0.97 (SD 0.98), and 0.87 (SD 1.02), respectively, with no significant difference (p = 0.436). The CSMS in the SLIT and SCIT groups was 0.96 and 0.78, respectively, without a statistically significant difference (p = 0.35). The mean VAS score was 2.44 cm (SD 2.41).

In 124 patients (81%), rhinitis was classified as mild, with a score <5 cm, with no statistically significant difference in the distribution of mild versus moderate/severe cases according to the time since completion of AIT (p = 0.074) or the type of AIT (p = 0.93). A strong, significant positive correlation was found between CSMS and VAS [correlation coefficient (r) = +0.61].

The demonstrated sustained effect of SLIT and SCIT with HDM and grass pollen on the severity of AR can be considered an indicator of long-term clinical benefit. Assessment of disease severity using VAS is reliable for evaluating the long-term effect of AIT and can be used in routine clinical practice.