Adherence and quality of life in adults and children during 3-years of SLIT treatment with Grazax—a real life study

Abstract

Respiratory allergic disease represents a global health problem, 30% of the population suffers from allergic rhinoconjunctivitis and 20% suffer from asthma. Allergy immunotherapy induce immunological tolerance and thereby modify the response to allergens and sublingual immunotherapy (SLIT) offers the possibility of home administration of allergen therapy, but adherence is more uncertain. The aim of the study was to investigate the adherence with GRAZAX in adults and children ≥ 5 years during three consecutive years of treatment. This was a non-interventional, prospective, observational, multi-center, open-label study to investigate adherence, quality of life, safety and tolerability of GRAZAX in adult and pediatric patients in a real-life setting. During the 3-years study period estimation of adherence was done regularly. Quality of life as well as symptom score was also assessed. In total, 399 patients (236 adults and 163 children) were included in the study. At baseline, 100% suffered from moderate-severe eyes and nose symptoms, and 31% had asthma in the grass pollen season. Overall, 55% completed a 3-years treatment period, whereas 37% stopped before end of study and 8% were lost to follow up. After 3 years, the adherence rate decreased from 98.2% (first month), 93.7% (first year), 93.2% (second year) and 88.9% (third year) and adverse events were the main reason for pre-term termination. The study suggests a good adherence to treatment in a real life setting among the patients finalizing 3-years SLIT therapy. The treatment was effective both on symptoms and HRQL.

Allergic reactions after vaccination: translating guidelines into clinical practice

“…In a short-term study on SCIT, 87.2% of patients were considered adherent (15), while in a 3-year study the adherence at the last year was 64.66% (18). In the two 3-years studies on adherence to SLIT, the same outcome was reported, 55% of patients completing the entire treatment (26,30). The only study comparing SCIT to SLIT reported a compliance rate of 58.7% in SCIT treated and 11.6% in SLIT treated patients (34).…”

“…The other topics were addressed in multiple studies. The most investigated was adherence and compliance, which was the subject of 5 studies (15,18,26,30). In a short-term study on SCIT, 87.2% of patients were considered adherent (15), while in a 3-year study the adherence at the last year was 64.66% (18).…”

Allergen Immunotherapy: Efficacy, Persistence, Consistency, and Cost Effectiveness

“…♦ The first 3-12 months, when most nonpersistence occurs with both SLIT and SCIT, are crucial for patient education, patient engagement, and follow-up [43,45,48,61,62].…”

“…♦ For SLIT local reactions, consider pretreatment with antihistamines, split tablet administration, moving tablet to other parts of vestibulum, and avoiding swallowing of the tablet [16,61].…”

Adherence to allergen immunotherapy

“…Wskaźnik adherence w przypadku AIT w opublikowanych analizach mieści się w granicach 40-70%. Są również takie prace, które wskazują, że wskaźnik ten sięga aż 90% [10,11,13]. Podobnie na wysoki odsetek adherence wskazały wyniki innego badania, real life, u chorych z alergią na jad owadów leczonych immunoterapią jadem (venom immunotherapy -VIT) przez 5 lat [14].…”