Allergen immunotherapy and health care cost benefits for children with allergic rhinitis: a large-scale, retrospective, matched cohort study

Hankin, Cheryl S.; Cox, Linda; Lang, David M.; Bronstone, Amy; Fass, Paul T.; Leatherman, Bryan; Wang, Zhaohui

doi:10.1016/j.anai.2009.11.010

Cited by 95 publications

(64 citation statements)

References 35 publications

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“…This data has led the authors to conclude that "This study demonstrates the potential suBlInguAl ImmunotHerApy In AllergIc rHInItIs orIgInAl ArtIcles And reVIews for early and significant cost savings in children with AR treated with immunotherapy. Greater use of this treatment in children could significantly reduce ARrelated morbidity and its economic burden" [40]. Of interest, the direct comparison of costs between ScIT and SLIT was in favour of the latter, as expected because of the lack of the necessity for hospital visits for the injections.…”

Section: Pharmacoeconomic Aspectsmentioning

confidence: 92%

Treating allergic rhinitis by sublingual immunotherapy: a review

Incorvaia

Rienzo

Celani

et al. 2012

Annali Dell'Istituto Superiore Di Sanità

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Abstract.Objective. Allergic rhinitis (AR) is a disease with high and increasing prevalence. The management of AR includes allergen avoidance, anti-allergic drugs, and allergen specific immunotherapy (AIT), but only the latter works on the causes of allergy and, due to its mechanisms of action, modifies the natural history of the disease. Sublingual immunotherapy (SLIT) was proposed in the 1990s as an option to traditional, subcutaneous immunotherapy. Material and methods. We reviewed all the available controlled trials on the efficacy and safety of SLIT. Results and conclusion. Thus far, more than 60 trials, globally evaluated in 6 meta-analyses, showed that SLIT is an effective and safe treatment for AR. However, it must be noted that to expect clinical efficacy in the current practice SLIT has to be performed following the indications from controlled trials, that is, sufficiently high doses to be regularly administered for at least 3 consecutive years.

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Section: Pharmacoeconomic Aspectsmentioning

confidence: 92%

Treating allergic rhinitis by sublingual immunotherapy: a review

Incorvaia

Rienzo

Celani

et al. 2012

Annali Dell'Istituto Superiore Di Sanità

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“…Children below 5 years of age have the lowest prevalence of AR; the rise in the incidence rate is registered in the primary-school age group [3]. Based on the research findings conducted according to the protocol GA2LEN (Global Allergy and Asthma European Network -Global network of allergy and asthma in Europe) in [2008][2009]., the prevalence of symptoms of allergic rhinitis in adolescents of 15-18 years was 34.2%, what prevails over the official statistics considerably [4]. Girls were significantly more indicated the presence of AR in comparison with boys (38.57 and 27.27%, respectively, p = 0.0001).…”

Section: Epidemiologymentioning

confidence: 99%

“…Pharmacoeconomic models, based on the data of clinical studies and meta-analyses indicate that ASIT is also cost-effective. The results of a cohort study of children with AR, conducted in the USA, indicated decrease of expenditures in the group of children undergoing ASIT by 33% [33,34].…”

Section: Immunotherapymentioning

confidence: 99%

Modern Principles of Allergic Rhinitis Therapy in Children

Вишнёва¹,

Намазова-баранова²,

Алексеева³

et al. 2014

Pediatr. farmakol.

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Modern principles of allergic rhinitis therapy in childrenAllergic diseases, the prevalence rate of which continues to grow, constitute a global issue for the world healthcare. Allergic rhinitis (AR) is a disease widespread among the children and adolescents, causing extensive socio-economic load as well as negative influence on the quality of life of both the patients and the members of their families [1−5]. Moreover, according to the results of the epidemiological studies, 10-40% of AR patients also suffer from bronchial asthma (BA). At the same time, almost 100% of BA patients, at least among the children, complain of AR manifestations. Constant sneezing, itching, rhinorrhea, nasal obstruction, cough and snoring, sleep disorders and fatigue negatively influence physical and psychological condition and social wellbeing, causing downslide in school performance [6]. Despite the presence of excruciating symptoms, the proven interconnection with and the influence on bronchial asthma, the issue of AR is often paid very little attention to, sometimes no more than a usual cold [5]. As a result, most of the pediatric patients either do not receive any adequate therapy they require, or are treated sporadically, taking palliative medications, falling out of modern treatment regimens. One of the reasons of this situation, which is not exclusively typical for our country, is the absence of guidelines on allergic rhinitis in children and its differences from the rhinitis in adults. The acute problem of choosing the correct treatment aiming at controlling the AR

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“…It is estimated that SIT is used in only about 2% to 6% of the approximate 55 million patients in the United States with allergic diseases. 66 Although perhaps being underused, allergen immunotherapy is most effective and safe for AR and provides a model system to evaluate the effects and mechanisms of allergen immunotherapy. Moreover, SIT treatment has led to a longer duration of symptom reduction compared with traditional pharmacotherapy.…”

Section: Allergen Immunotherapy In Armentioning

confidence: 99%

Allergen Immunotherapy in Allergic Respiratory Diseases

Viswanathan

Busse

2012

Chest

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Over the past 2 decades, the prevalence of allergic respiratory diseases has increased, in part refl ecting changes in lifestyle and environment that promote a T-helper (Th) 2 cell phenotype. 1 It has been estimated that up to 20% of the US and Western Europe populations may be affl icted by allergic respiratory diseases. 2,3 A recent estimate of the total national medical expenditure attributable to adult asthma was reported as $18 billion, with the largest contributors being prescription drugs and inpatient hospitalizations. 4,5 Although allergen avoidance is an integral component and step of therapy, it is often impractical and insuffi cient. As a consequence, the mainstay of allergic disease management has been pharmacotherapy, especially antihistamines, bronchodilators, and inhaled/intranasal corticosteroids, which are targeted to regulate infl ammation of the upper and lower airways. Although these treatments are effective and, in most cases, safe, they offer no lasting benefi t once treatment is stopped and have limited intrinsic disease-modifying effects. Moreover, it has become apparent that allergic diseases are the result of immune dysregulation and refl ect an impairment in the natural tolerance that develops to allergens. 6,7 Immunotherapy has the potential to modify fundamental, underlying disease mechanisms and to have, Allergen-specifi c immunotherapy (SIT) involves the repeated administration of allergenic extracts to atopic individuals over a period of 3 to 5 years either subcutaneously (SCIT) or sublingually (SLIT) for the treatment of allergic respiratory diseases, including asthma and allergic rhinitis (AR). In studies, SCIT and SLIT have been shown to improve existing symptoms of asthma and AR and to also have the capability to cause disease-modifying changes of the underlying atopic condition so as to prevent new allergic sensitization as well as arrest progression of AR to asthma. Recent evidence suggests that immunotherapy brings about these effects through actions that use T-regulatory cells and blocking antibodies such as IgG 4 and IgA 2, which can then result in an "immune deviation" from a T-helper (Th) 2 cell pattern to a Th1 cell pattern. Numerous meta-analyses and studies have been performed to evaluate the existing data among these studies, with the consensus recommendation favoring the use of immunotherapy because of its potential to modify existing diseases. Signifi cant adverse reactions can occur with immunotherapy, including anaphylaxis and, very rarely, death. A primary factor in considering SIT is its potential to provide longlasting effects that are able to be sustained well after its discontinuation. Given the signifi cant burden these allergic diseases impose on the health-care system, SIT appears to be a cost-effective adjunctive treatment in modifying the existing disease state. CHEST 2012; 141(5):1303-1314Abbreviations: AR 5 allergic rhinitis; BHR 5 bronchial hyperresponsiveness; PEF 5 peak expiratory fl ow; SCIT 5 subcutaneous immunotherapy; SIT 5 allergen-specifi c...

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Allergen immunotherapy and health care cost benefits for children with allergic rhinitis: a large-scale, retrospective, matched cohort study

Cited by 95 publications

References 35 publications

Treating allergic rhinitis by sublingual immunotherapy: a review

Treating allergic rhinitis by sublingual immunotherapy: a review

Modern Principles of Allergic Rhinitis Therapy in Children

Allergen Immunotherapy in Allergic Respiratory Diseases

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