Allergen immunotherapy in MASK‐air users in real‐life: Results of a Bayesian mixed‐effects model
Authors: Sousa‐Pinto Bernardo , Azevedo Luís Filipe , Sá‐Sousa Ana , Vieira Rafael José , Amaral Rita , Klimek Ludger , Czarlewski Wienczyslawa , Anto Josep M. , Bedbrook Anna , Kvedariene Violeta , Ventura Maria Teresa , Ansotegui Ignacio J. , Bergmann Karl‐Christian , Brussino Luisa , Canonica G. Walter , Cardona Victoria , Carreiro‐Martins Pedro , Casale Thomas , Cecchi Lorenzo , Chivato Tomás , Chu Derek K. , Cingi Cemal , Costa Elisio M. , Cruz Alvaro A. , De Feo Giulia , Devillier Philippe , Fokkens Wytske J. , Gaga Mina , Gemicioğlu Bilun , Haahtela Tari , Ivancevich Juan Carlos , Ispayeva Zhanat , Jutel Marek , Kuna Piotr , Kaidashev Igor , Kraxner Helga , Larenas‐Linnemann Désirée E. , Laune Daniel , Lipworth Brian , Louis Renaud , Makris Michaël , Monti Riccardo , Morais‐Almeida Mario , Mösges Ralph , Mullol Joaquim , Odemyr Mikaëla , Okamoto Yoshitaka , Papadopoulos Nikolaos G. , Patella Vincenzo , Pham‐Thi Nhân , Regateiro Frederico S. , Reitsma Sietze , Rouadi Philip W. , Samolinski Boleslaw , Sova Milan , Todo‐Bom Ana , Taborda‐Barata Luis , Tomazic Peter Valentin , Toppila‐Salmi Sanna , Sastre Joaquin , Tsiligianni Ioanna , Valiulis Arunas , Wallace Dana , Waserman Susan , Yorgancioglu Arzu , Zidarn Mihaela , Zuberbier Torsten , Fonseca João Almeida , Bousquet Jean , Pfaar Oliver 
Published: March 2022

Background

Evidence regarding the effectiveness of allergen immunotherapy (AIT) on allergic rhinitis has been provided mostly by randomised controlled trials, with little data from real‐life studies.

Objective

To compare the reported control of allergic rhinitis symptoms in three groups of users of the MASK‐air® app: those receiving sublingual AIT (SLIT), those receiving subcutaneous AIT (SCIT), and those receiving no AIT.

Methods

We assessed the MASK‐air® data of European users with self‐reported grass pollen allergy, comparing the data reported by patients receiving SLIT, SCIT and no AIT. Outcome variables included the daily impact of allergy symptoms globally and on work (measured by visual analogue scales—VASs), and a combined symptom‐medication score (CSMS). We applied Bayesian mixed‐effects models, with clustering by patient, country and pollen season.

Results

We analysed a total of 42,756 days from 1,093 grass allergy patients, including 18,479 days of users under AIT. Compared to no AIT, SCIT was associated with similar VAS levels and CSMS. Compared to no AIT, SLIT‐tablet was associated with lower values of VAS global allergy symptoms (average difference = 7.5 units out of 100; 95% credible interval [95%CrI] = −12.1;−2.8), lower VAS Work (average difference = 5.0; 95%CrI = −8.5;−1.5), and a lower CSMS (average difference = 3.7; 95%CrI = −9.3;2.2). When compared to SCIT, SLIT‐tablet was associated with lower VAS global allergy symptoms (average difference = 10.2; 95%CrI = −17.2;−2.8), lower VAS Work (average difference = 7.8; 95%CrI = −15.1;0.2), and a lower CSMS (average difference = 9.3; 95%CrI = −18.5;0.2).

Conclusion

In patients with grass pollen allergy, SLIT‐tablet, when compared to no AIT and to SCIT, is associated with lower reported symptom severity. Future longitudinal studies following internationally‐harmonised standards for performing and reporting real‐world data in AIT are needed to better understand its ‘real‐world’ effectiveness.