Characteristics of Patients with Respiratory Allergy in France and Factors Influencing Immunotherapy Prescription: A Prospective Observational Study (Realis)

Abstract

To describe the sensitization profile of respiratory allergies in France, identifying factors influencing the prescription of allergen immunotherapy (AIT) [Transversal phase (T»), and assess treatment efficacy, tolerability, compliance and satisfaction [Longitudinal phase (L»). French allergists (600) and pneumo-allergists (600) were offered participation and asked to recruit the first 20 new patients with allergic rhinitis (AR) and/or asthma, consulting for a first time allergy check-up with skin prick-test (T), and 5 patients sensitized to pollens (skin test and/or specific IgE) for whom SLIT with pollens was prescribed (L). In the T phase, 2,714 patients were recruited by 169 specialists, mostly allergists (76.5%). The majority (98%) suffered fromAR, alone (57.7%) or with asthma (40.3%) and 80.3% suffered from moderate-to-severe rhinitis, mostly persistent (65.8%). Asthma, when present, was mostly intermittent (63.7%) or mild persistent (20.1%). Sensitization to house dust mites was the most common (64.5%), followed by grass pollens (61.5%), tree pollens (41.6%) and cat danders (30.5%). Poly-sensitization was seen in 73.6% of patients. AIT, mostly sublingual, was recommended in 55.6% of the patients, mostly (78.1%) because of insufficient control with symptomatic treatments. The overall impact of symptoms on QOL, positive skin test to grass pollens, ocular pruritus and/or nasal obstruction and moderateto-severe rhinitis were significant predictors of SLIT prescription. Poly-sensitization or concomitant asthma were not seen as deterrents. Most patients consulting a specialist for allergy testing suffer from moderate-to-severe rhinitis. Treatment in current practice includes immunotherapy in half of the patients, and follows ARIA recommendations.Allergic rhinitis (AR) represents a global health, problem affecting 10% to 20% of the population (I). In Western Europe it is estimated that around 20% of the general population suffer from allergic rhinitis (2-3). Many patients with rhinitis also suffer from asthma (4-5).Exposure to ihhaled allergens and genetic predisposition have been recognized as important

The European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): A paediatric assessment

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Allergic Rhinitis and its Impact on Asthma (ARIA): Achievements in 10 years and future needs

“…90,91 GLOBAL APPLICABILITY OF ARIA AND UNMET NEEDS Many unmet needs for AR have been published. In this document, unmet needs specific to ARIA are proposed from existing ARIA documents.…”

Pollen‐induced allergic rhinitis in 1360 Italian children: Comorbidities and determinants of severity

“…To our knowledge, no other pediatric study has examined similar North‐South gradients at country level in Europe and linked to markers of disease severity or comorbidities. Geographic differences of sensitization patterns in patients with respiratory allergies have been reported in Spain or France , but they focused on coast vs. continental areas rather than a North‐South gradient. Given its geographic characteristic (a country elongated from North to South), Italy can reproduce better than other countries the North‐South gradients typically observed, on a wider scale, at European level.…”