Affiliation:
1. Department of Epidemiology Research Statens Serum Institut Copenhagen Denmark
2. Center for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Department of Clinical Medicine Aalborg University Copenhagen Denmark
3. Cancer Epidemiology and Surveillance Danish Cancer Institute Copenhagen Denmark
4. Danish Cancer Institute Copenhagen Denmark
5. Department of Genetics Stanford University School of Medicine Stanford California USA
6. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
7. K.G. Jebsen Center for Genetic Epidemiology Norwegian University of Science and Technology Trondheim Norway
Abstract
AbstractBackgroundBecause long‐term effectiveness of pollen allergen immune therapy (AIT) for allergic rhinitis (AR) is not well‐described, we studied effectiveness over 18 years in Denmark.MethodsA register‐based cohort study using data on filled prescriptions, 1995–2016, Denmark. In a cohort of 1.1 million intranasal corticosteroid inhaler users (proxy for AR), we matched users treated with grass, birch or mugwort AIT 1:2 with non‐treated users on baseline year and 24 characteristics in the 3 years prior to baseline. The primary outcome was the odds ratio (OR) of using anti‐allergic nasal inhaler during the pollen season in the treated versus non‐treated group by years since baseline.ResultsAmong 7760 AR patients treated with pollen AIT, the OR of using nasal inhaler 0–5 years after baseline was reduced when compared with 15,520 non‐treated AR individuals (0–2 years, OR 0.84 (0.81–0.88); 3–5 years, OR 0.88 (0.84–0.92)), but was close to unity or higher thereafter (6–9 years, OR 1.03 (0.97–1.08); 10–18 years, OR 1.18 (1.11–1.26)). In post hoc analyses, results were more consistent for those who already had 3 of 3 baseline years of use, and in patients using nasal inhaler in the latest pollen season (0–2 years, OR 0.76 (0.72–0.79); 3–5 years OR 0.86 (0.81–0.93); 6–9 years, OR 0.94 (0.87–1.02); 10–18 years, OR 0.94 (0.86–1.04)) as opposed to no such use.ConclusionsPatients treated with pollen AIT in routine care to a higher degree stopped using anti‐allergic nasal inhaler 0–5 years after starting the standard 3 years of therapy, and not beyond 5 years. Post hoc analyses suggested effectiveness was more consistent among patients with persistent AR.
Funder
Aase og Ejnar Danielsens Fond
Fonden til Lægevidenskabens Fremme
Dagmar Marshalls Fond
Helsefonden
Hartmann Fonden
Oak Foundation
Subject
Immunology,Immunology and Allergy