Published Online: September 11, 2015
Allergic rhinitis (AR) is among the most prevalent chronic conditions, and it constitutes a high healthcare burden. Many patients with chronic AR develop asthma. Preliminary clinical trials suggested that allergy immunotherapy (AIT), the only causal treatment option in AR, reduces the risk of developing asthma in patients with AR. However, as trial participants are frequently not representative of patients in routine care, the clinical effectiveness of AIT to prevent new-onset asthma deserves further investigation.
In an article recently published in The Journal of Allergy & Clinical Immunology (JACI), Schmitt and colleagues investigated the effectiveness of AIT to prevent asthma in a cohort of 118,754 patients with AR. The retrospective cohort study utilized administrative healthcare data from German National Health Insurance beneficiaries. The authors compared the risk of developing asthma in patients who received AIT in 2006 compared to AR patients without AIT. Patients were followed until the end of 2012.
The researchers found that AR patients who received AIT had an approximately 40% decreased risk of developing asthma. This is compared to AR patients who did not receive AIT, controlling for potential confounders such as age, sex, healthcare utilization due to AR, and use of antihistamines. The authors further found that the preventive effectiveness of AIT is highest when subcutaneous immunotherapy (SCIT) is used, when AIT including native allergens is used, and when AIT is given for 3 years or longer.
These findings indicate that AIT can effectively prevent asthma in AR patients in a realistic clinical setting. These findings are important for clinical decision-making, as asthma is associated with high morbidity, quality of life impairments, and cost.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.