Preference for sublingual immunotherapy with tablets in a Spanish population with allergic rhinitis

Abstract

Background This study investigated patients' preference for allergy immunotherapy (AIT) administered as either sublingual immunotherapy‐tablets versus monthly or weekly subcutaneous immunotherapy (SCIT) from a Spanish patient perspective. Methods A discrete choice experiment (DCE) consisting of two blocks with eight choice sets in each was constructed to elicit the preferences for AIT. Three attributes were included in the DCE for the mode of administration, including the frequency of administration, the risk of systemic reactions and the co‐payment. Adults and caregivers of children with moderate to severe allergic rhinitis (AR) were included if they were not currently receiving or had not previously received AIT. Results In total, 587 adults and 613 caregivers started the survey. Of those, 579 adults and 611 caregivers completed the survey and were included in the study. Both adults and caregivers had a significant preference for tablets compared with both monthly and weekly injections ( p ≤ 0.0001). Furthermore, the respondents showed a significant preference for reducing the risk of systemic reactions. Subgroup analyses showed that caregivers of polyallergic children and female caregivers were significantly less price sensitive when choosing their preferred treatment. Conclusion Our study demonstrated that both adults with AR and caregivers of children with AR prefer daily SLIT‐tablets to SCIT with either a weekly or monthly dose schedule.

SQ sublingual immunotherapy tablets for children with allergic rhinitis: A review of phase three trials

“…49 Studies have also demonstrated a significant preference for SLIT tablets versus SCIT among caregivers of children with allergic rhinitis. 15,16 These findings are supported by a recent systematic review and meta-analysis of SLIT drops and tablets versus SCIT in children with allergic rhinitis. 50 Whilst acknowledging the limited availability of head-to-head studies of SLIT and SCIT and the heterogeneous evidence base, the analysis suggested that SLIT may be superior to SCIT in terms of treatment-related adverse events, potentially making it a more favourable choice in paediatric populations.…”

“…2 Consequently, patient preference regarding the administration form of AIT (SCIT or SLIT) should be considered to ensure optimal adherence during the three-year treatment period. 2,15,16 SLIT can be administered in the form of drops or tablets. 2 Robust clinical evidence for SCIT and SLIT drops in paediatric populations is limited.…”

“…Reductions in clinical symptoms and symptom‐relieving medication use can be observed from the beginning of the first pollen season following AIT initiation 2 . Consequently, patient preference regarding the administration form of AIT (SCIT or SLIT) should be considered to ensure optimal adherence during the three‐year treatment period 2,15,16 . SLIT can be administered in the form of drops or tablets 2 .…”

Adherence and persistence in allergen immunotherapy (APAIT): A reporting checklist for retrospective studies

“…Indeed, reports from the literature suggest that the majority of patients prefer SLIT (tablets) over SCIT and, that taking these preferences into account when deciding the course of treatment, could improve adherence. 35,36 However, with SLIT treatment, current adherence and persistence monitoring methods do not provide a guarantee that patients have taken their treatment or that it has been administered correctly. By contrast, all SCIT injections are delivered in the clinic and documented in the patient medical records meaning that adherence and persistence are transparent.…”

“…In contrast, the convenience of at‐home treatment provided by SLIT tablets would support better adherence and persistence. Indeed, reports from the literature suggest that the majority of patients prefer SLIT (tablets) over SCIT and, that taking these preferences into account when deciding the course of treatment, could improve adherence 35,36 . However, with SLIT treatment, current adherence and persistence monitoring methods do not provide a guarantee that patients have taken their treatment or that it has been administered correctly.…”