RWD Analyses on AIT Long-Term Effects
In contrast to symptomatic medication, AIT is the only causal treatment
option for IgE-mediated allergic diseases and therefore has the
potential for long-term effects that last after termination of therapy
(1,2). There are a few RCTs showing long-term efficacy for single SCIT
and SLIT preparations in allergic rhinitis (37–42) for up to five years
after terminating three years of AIT. In children, one of these trials
additionally showed a reduced risk of experiencing asthma symptoms or
using asthma medication while there was no difference in time to onset
of asthma during the two-year follow-up period (41). Data from different
real-world settings e.g. non-interventional studies or analyses in
claims databases, patients surveys, electronic health records or product
and disease registries allow to analyze the effectiveness and medication
adherence under practical conditions (10,43) and the evaluation of
long-term data for larger patient populations and even longer follow-up
periods without the risk of ethical concerns arising from withholding a
therapy proven to be effective in placebo groups in 5-years’ DBPC AIT
studies.
This review summarizes results from thirteen publications dealing with
retrospective cohort assessments of national prescription databases in
Europe. All nine assessments investigating effectiveness consistently
showed long-term effectiveness for AIT in allergic rhinitis for
different time periods; long-term effectiveness for AIT in asthma as
well as the asthma preventive effect was proven in most studies
(15–19,21,22,25,26). Therefore, the findings from the RWD summarized
here are in line with those observed in RCTs showing long-term
effectiveness of AIT in allergic rhinitis and asthma as well as asthma
preventive effects (37–42). Since national and international
allergology societies (1,2,44) demand an individual product-based
efficacy evaluation respective long-term RWD for more individual AIT
preparations are desirable.