Dataset Information

Clinical Efficacy of Allergen-Specific Immunotherapy from Patient and Physician Perspectives.

ABSTRACT:

Purpose

Allergen-specific immunotherapy (AIT) is the only curative treatment for allergic diseases, but a few allergic patients receive AIT. In this multicenter cross-sectional study, we aimed to explore patient and physician perspectives on AIT through a questionnaire survey.

Materials and methods

Allergic patients who received subcutaneous immunotherapy for at least 1 year were asked to answer a questionnaire developed by an expert panel of allergen and immunotherapy workgroup in Korea.

Results

A total of 267 patients (adults, 60.3%) with allergic rhinitis (91.4%), asthma (42.7%), or atopic dermatitis (20.2%) from referred hospitals completed the survey. Among patients and physicians, respectively, the overall rates of satisfaction with AIT for allergic rhinitis were 86.4% and 83.3% (kappa agreement=0.234, p<0.001), and those for asthma were 85.3% and 72.9% (kappa agreement=0.373, p<0.001). Moreover, pediatric asthmatic patients reported a significantly higher satisfaction rate than adult asthmatic patients after AIT (p=0.040). Symptom severity (p<0.001, respectively) and drug use for allergic rhinitis and asthma decreased after AIT. However, there was no significant difference in satisfaction rates between children and adults in allergic rhinitis (p=0.736). Interestingly, 35.7% and 35% of allergic rhinitis and asthma patients, respectively, reported experiencing improvement in their symptoms within 6 months of starting AIT.

Conclusion

In this study evaluating the perspectives of patients and physicians on AIT, the majority of patients were satisfied with the efficacy and safety of AIT, but not its cost. AIT should be recommended for AR and allergic patients.

SUBMITTER: Shin YS

PROVIDER: S-EPMC6479127 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Clinical Efficacy of Allergen-Specific Immunotherapy from Patient and Physician Perspectives.

Shin Yoo Seob YS Jung Jae Woo JW Park Jung Won JW Choi Jeong Hee JH Kwon Jae Woo JW Lee Sooyoung S Kim Ji Hye JH Lee Sang Min SM Ahn Young Min YM Han Man Yong MY

Yonsei medical journal 20190501 5

<h4>Purpose</h4>Allergen-specific immunotherapy (AIT) is the only curative treatment for allergic diseases, but a few allergic patients receive AIT. In this multicenter cross-sectional study, we aimed to explore patient and physician perspectives on AIT through a questionnaire survey.<h4>Materials and methods</h4>Allergic patients who received subcutaneous immunotherapy for at least 1 year were asked to answer a questionnaire developed by an expert panel of allergen and immunotherapy workgroup i ...[more]

PMID: 31016906

Similar Datasets

Project description:BackgroundThe Allergy Patient Identification for Immunotherapy (AsPIRe) program was a parallel physician and patient survey. The objectives were to examine physician and patient perceptions of seasonal allergy symptoms and their impact on patients, and to examine patient and physician attitudes to allergen immunotherapy (AIT) for seasonal allergies. AsPIRe was led by a steering committee and received research ethics board clearance from Queen's University.MethodsAllergists (17) from across Canada enrolled in the AsPIRe program and completed an on-line survey to collect demographic information and baseline perceptions. Allergists then recruited patients and completed paper-based parallel physician and patient questionnaires. Patients received an AIT informational booklet with their questionnaire. Patients who were AIT-naïve with no contraindication to AIT and 12 years of age and older met the inclusion criteria.ResultsThe survey was in field from February 2018 to June 2018. A total of 141 allergist surveys and 136 patient surveys were completed. Mean age of patients was 30 years old (range 12-70). Fifty-seven percent of patients reported prior knowledge of AIT. Seventy-two percent of patients reported seasonal allergies of longer than 5 years duration and in this subset of patients, 46% were at their first allergist visit. Seventy-three percent of all patients indicated they would be likely or very likely to try sublingual immunotherapy (SLIT), if recommended by their allergist compared to 36% for subcutaneous immunotherapy (SCIT). Conversely, 10% of patients reported they would be unlikely or very unlikely to try SLIT compared to 46% of patients who would be unlikely or very unlikely to try SCIT if recommended by their allergist.ConclusionsIn this particular study cohort, there was a gap in perception between allergists and their patients as to the impact of allergy symptoms on daily life. Patients reported being more frequently impacted vs. their physician's assessment. When asked about preference for AIT options, Canadian patients reported they were more likely to follow their allergists' recommendation for initiation of SLIT compared to SCIT.

Project description:BackgroundWhile allergen-specific immunotherapy (AIT) is acknowledged as an effective treatment, its efficacy varies, and consensus on predictive indicators for AIT responders remains elusive.ObjectiveThis study aimed to identify alternative parameters for predicting AIT responders based on clinical data collected in daily practice.MethodWe conducted a retrospective analysis of patients with house-dust-mite-driven asthma and/or rhinitis who completed 3 years of subcutaneous AIT (3y-AIT). We assessed the efficacy of AIT using the estimated daily symptom and medication score (edSMS) during different treatment periods, including up-dosing, maintenance I, II, and III phases. These scores were derived from detailed records of symptoms and medication use for AIT injections. A responder was defined as an individual with a reduction in edSMS of at least 30% from up-dosing to maintenance III phase (ΔedSMSU-M3).ResultsA cohort of 133 patients was analyzed, revealing a significant overall improvement in the disease condition after 3y-AIT. Responders demonstrated lower rates of polysensitization, daily tobacco smoke exposure, and milder pretreatment disease severity compared to non-responders (p = 0.003, p = 0.001, and p = 0.019, respectively). We observed 8 clinical response patterns among included subjects, but only a small group of patients (16/133, 12.03%) demonstrated consistent improvement throughout the 3y-AIT. Serum total immunoglobulin E (tIgE), specific immunoglobulin E (sIgE), sIgE/tIgE ratios, and edSMS during the up-dosing phase failed to differentiate the clinical response patterns or correlate with 3y-AIT efficacy. Notably, the reduction in edSMS from up-dosing phase to maintenance I phase (ΔedSMSU-M1) significantly associated with the 3y-AIT outcome (r = 0.443, p < 0.001). Receiver-operating characteristic curves indicated that ΔedSMSU-M1, with a cut-off of 18.40%, effectively predicted responders (AUC: 0.75, sensitivity: 76.20%, specificity: 76.70%).ConclusionThe individualized clinical responses to AIT may pose challenges in identifying predictors for treatment efficacy. Nonetheless, despite this complexity, our study highlights that the effectiveness observed in the early maintenance phase serves as a suitable predictor of 3y-AIT outcomes.

Dataset Information

Clinical Efficacy of Allergen-Specific Immunotherapy from Patient and Physician Perspectives.

Purpose

Materials and methods

Results

Conclusion

Publications

Clinical Efficacy of Allergen-Specific Immunotherapy from Patient and Physician Perspectives.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets