■呼吸道过敏,通常表现为过敏性鼻炎(AR)和哮喘,是一种慢性进行性疾病,通常始于儿童时期。过敏免疫疗法(AIT)是呼吸道过敏的唯一病因治疗方法,有可能改变过敏的根本原因,最终,防止疾病进展。该分析旨在确定AIT是否足够早地接受以阻止过敏性疾病的进展。通过在现实生活中的临床实践中描述AIT开始之前儿童的疾病负担和进展。
■变态反应免疫疗法的REAl-world有效性研究(REACT)是一项大型回顾性队列研究,使用2007年至2017年之间的德国索赔数据。来自REACT研究的两个预定义AIT年龄组的特征-儿童(年龄<18岁)和成人(年龄≥18岁)-在第一个AIT处方之前的1年内进行了评估。为了比较,纳入所有确诊为AR且无AIT处方的受试者的对照组.使用特应性合并症的诊断代码评估疾病负担[例如,特应性皮炎(AD),哮喘,和急性过敏性结膜炎]和非特应性合并症(例如,偏头痛,头痛);药物使用,记录为缓解症状的AR药物和缓解/控制哮喘药物的处方,也进行了评估。数据进行了描述性分析,使用汇总统计数据。
■与未接受AIT治疗的AR患者相比,儿童(n=11,036)和成人(n=30,037)在AIT开始前表现出更高的特应性合并症患病率和更大的药物负担(n=1,003,332)。在两个特定年龄的AIT队列中,与成人相比,儿童始终表现出最高的特应性合并症患病率(AIT儿童,AIT成人-哮喘:41.4%,34.5%;AD:19.9%,10.2%;急性过敏性结膜炎:13.6%,10.2%)。一般来说,开始AIT的儿童每年缓解症状的AR和哮喘治疗的处方也较高。成人(AIT儿童,AIT成人-每位受试者的AR处方:1.72,0.73;每位受试者的哮喘处方:1.42,0.79)。
■在现实生活中获得AIT的AR儿童在开始之前表现出相当大的疾病负担。由于AIT可以减轻过敏性疾病的负担并阻止其进展,在病程早期考虑AIT可能是必要的.
UNASSIGNED: Respiratory allergy, commonly manifesting as allergic rhinitis (AR) and asthma, is a chronic progressive disease that frequently starts in childhood. Allergy immunotherapy (AIT) is the only causal treatment for respiratory allergy with the potential to modify the underlying cause of allergy and, ultimately, prevent disease progression. This analysis aimed to determine if AIT is received sufficiently early to halt the progression of allergic disease, by characterizing the burden and progression of disease in children prior to AIT initiation in real-life clinical practice.
UNASSIGNED: The REAl-world effeCtiveness in allergy immunoTherapy (REACT) study was a large retrospective cohort study using German claims data between 2007 and 2017. Characteristics of two pre-defined AIT age cohorts from the REACT study - children (aged <18 years) and adults (aged ≥18 years) - were evaluated during the 1-year period before the first AIT prescription. For comparison, a control group of all subjects with a confirmed diagnosis of AR and without prescriptions for AIT was included. Burden of disease was assessed using diagnostic codes for atopic comorbidities [e.g., atopic dermatitis (AD), asthma, and acute allergic conjunctivitis] and non-atopic comorbidities (e.g., migraine, headache); medication use, recorded as prescriptions for symptom-relieving AR medication and reliever/controller medication for asthma, was also assessed. Data were analyzed descriptively, using summary statistics.
UNASSIGNED: Both children (n = 11,036) and adults (n = 30,037) showed a higher prevalence of atopic comorbidities and a greater drug burden prior to AIT initiation compared to AR patients not treated with AIT (n = 1,003,332). In the two age-specific AIT cohorts, children consistently showed the highest prevalence of atopic comorbidities compared to adults (AIT children, AIT adults - asthma: 41.4%, 34.5%; AD: 19.9%, 10.2%; acute allergic conjunctivitis: 13.6%, 10.2%). Generally, prescriptions per year for symptom-relieving AR and asthma treatments were also higher for children initiating AIT vs. adults (AIT children, AIT adults - AR prescriptions per subject: 1.72, 0.73; asthma prescriptions per subject: 1.42, 0.79).
UNASSIGNED: Children with AR who are offered AIT in real-life show considerable disease burden prior to initiation. As AIT may alleviate the burden and halt the progression of allergic disease, considering AIT earlier in the disease course may be warranted.