Allergen-specific immunotherapy and real-world evidence

Abstract

Allergen immunotherapy is the most common method of treating IgE-dependent allergic disorders in clinical practice. Despite the enormous amount of data from randomized placebo-controlled trials on allergen immunotherapy efficacy, a lot of questions regarding the efficacy of allergen immunotherapy in practice remain unanswered. These questions can be answered using real-world evidence. In conducting real-world evidence investigations of allergen immunotherapy, it is necessary to follow a strict methodology and perform a multivariate analysis of the available data. The use of statistical methods reduces the risk of bias. The REACT study, which included more than 90,000 patients with allergic rhinitis from Germany, is currently the largest and the most comprehensive real-world evidence study of allergen immunotherapy. To ensure comparable groups and representative data, a propensity score match statistical adjustment procedure was applied. The REACT study provided results of fundamental clinical and public health significance: the allergen immunotherapy leads to a sustained and long-term reduction in drug prescription in patients with allergic rhinitis and asthma, improved control of asthma, and also prevents the development of exacerbations and respiratory infections in asthma patients. The REACT study is a good quality real-world evidence study with strict methodology and representative results. Further high-quality standard studies of real-world data may not only confirm the randomized trial evidence but also may become a source of new evidence of the efficacy and safety of allergen immunotherapy in clinical practice.