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Allergy immunotherapy prevents asthma in patients with allergic rhinitis

Patients with allergic rhinitis who underwent allergy immunotherapy appeared significantly less likely to be diagnosed with asthma, according to study results.

“Allergy immunotherapy effectively prevents the progression of allergic rhinitis to asthma in a real-life setting. This asthma-preventive effect is strongest in products containing native allergens,” Jochen Schmitt, MD, MPH, of the Center for Evidence-based Healthcare at Medical Faculty Carl Gustav Carus in Germany, and colleagues wrote. “By reducing the risk for asthma, significant health care costs can be saved. Allergy immunotherapy should be initiated early in the allergic disease and be continued for at least 3 years.”

Schmitt and colleagues used health care data provided by German National Health Insurance beneficiaries to identify 118,754 patients with allergic rhinitis. Researchers divided patients into two groups — those who received allergy immunotherapy (n = 2,431) and those who did not (n = 116,423).

The investigators analyzed patients at risk for asthma during a 5-year follow-up period.

The most common type of allergy immunotherapy administered was subcutaneous immunotherapy (SCIT; 83.6%), followed by sublingual immunotherapy (SLIT) tablets (10.2%).

Overall, 1,646 patients developed asthma during follow-up.

Results showed patients who began allergy immunotherapy were significantly less likely to develop asthma (RR = 0.6; 95% CI, 0.42-0.84).

A sensitivity analysis showed the significant preventive effects of SCIT (RR = 0.57; 95% CI, 0.38-0.84) and allergy immunotherapy, including native allergens (RR = 0.22; 95% CI, 0.02-0.68).

However, researchers observed no significant preventive effects of SLIT drops (RR = 0.43; 95% CI, 0.14-1.33), or with the combination of SCIT and SLIT (RR = 1.22; 95% CI, 0.52-2.99).

The analysis also revealed that 3 years or more of allergy immunotherapy (RR = 0.62; 95% CI, 0.39-0.98) was associated with stronger preventive effects than less than 3 years of allergy immunotherapy (RR = 0.57; 95% CI, 0.34-0.94). – Jeff Craven

Disclosure: Schmitt reports research support from Abbott, ALK-Abello, MSD, Novartis and Pfizer. One other researcher reports employment with and stock options from ALK-Abello.