Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference
Sousa-Pinto B. Schünemann H.J. Sá-Sousa A. Vieira R. Amaral R. Anto J.M. Klimek L. Czarlewski W. Mullol J. Pfaar O. Bedbrook A. Brussino L. Kvedariene V. Larenas-Linnemann D. Okamoto Y. Ventura M.T. Agache I. Ansotegui I. Bergmann K.C. Bosnic-Anticevich S. Brozek J. Canonica G.W. Cardona V. Carreiro-Martins P. Casale T. Cecchi L. Chivato T. Chu D.K. Cingi C. Costa E.M. Cruz A.A. Del Giacco S. Devillier P. Eklund P. Fokkens W.J. Gemicioglu B. Haahtela T. Ivancevich J.C. Ispayeva Z. Jutel M. Kuna P. Kaidashev I. Khaitov M. Kraxner H. Laune D. Lipworth B. Louis R. Makris M. Monti R. Morais-Almeida M. Mösges R. Niedoszytko M. Papadopoulos N.G. Patella V. Pham-Thi N. Regateiro F.S. Reitsma S. Rouadi P.W. Samolinski B. Sheikh A. Sova M. Todo-Bom A. Taborda-Barata L. Toppila-Salmi S. Sastre J. Tsiligianni I. Valiulis A. Vandenplas O. Wallace D. Waserman S. Yorgancioglu A. Zidarn M. Zuberbier T. Fonseca J.A. Bousquet J.
October 2022John Wiley and Sons Inc
Allergy: European Journal of Allergy and Clinical Immunology
2022#77Issue 103002 - 3014 pp.
Background: Different treatments exist for allergic rhinitis (AR), including pharmacotherapy and allergen immunotherapy (AIT), but they have not been compared using direct patient data (i.e., “real-world data”). We aimed to compare AR pharmacological treatments on (i) daily symptoms, (ii) frequency of use in co-medication, (iii) visual analogue scales (VASs) on allergy symptom control considering the minimal important difference (MID) and (iv) the effect of AIT. Methods: We assessed the MASK-air® app data (May 2015–December 2020) by users self-reporting AR (16–90 years). We compared eight AR medication schemes on reported VAS of allergy symptoms, clustering data by the patient and controlling for confounding factors. We compared (i) allergy symptoms between patients with and without AIT and (ii) different drug classes used in co-medication. Results: We analysed 269,837 days from 10,860 users. Most days (52.7%) involved medication use. Median VAS levels were significantly higher in co-medication than in monotherapy (including the fixed combination azelastine-fluticasone) schemes. In adjusted models, azelastine-fluticasone was associated with lower average VAS global allergy symptoms than all other medication schemes, while the contrary was observed for oral corticosteroids. AIT was associated with a decrease in allergy symptoms in some medication schemes. A difference larger than the MID compared to no treatment was observed for oral steroids. Azelastine-fluticasone was the drug class with the lowest chance of being used in co-medication (adjusted OR = 0.75; 95% CI = 0.71–0.80). Conclusion: Median VAS levels were higher in co-medication than in monotherapy. Patients with more severe symptoms report a higher treatment, which is currently not reflected in guidelines.
allergen immunotherapy , allergic rhinitis , co-medication , multivariable mixed-effects model , real-world data
Text of the article Перейти на текст статьи
MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal
RISE – Health Research Network, University of Porto, Porto, Portugal
Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Universitat Pompeu Fabra (UPF), Barcelona, Spain
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, and Center for Rhinology and Allergology, Wiesbaden, Germany
Medical Consulting Czarlewski, Levallois, France
Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
ARIA, Montpellier, France
Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy
Transylvania University Brasov, Brasov, Romania
Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, and Sydney Local Health District, Sydney, NSW, Australia
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
Allergy Section, Department of Internal Medicine, Hospital Vall dHebron & ARADyAL Research Network, Barcelona, Spain
Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
Division of Allergy/Immunology, University of South Florida, Tampa, FL, United States
SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
School of Medicine, University CEU San Pablo, Madrid, Spain
Department of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Brazil
Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital Duilio Casula, University of Cagliari, Cagliari, Italy
VIM Suresnes, UMR_0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
Department of Computing Science, Umeå University, Umeå, Sweden
Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, Netherlands
Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
President of Kazakhstan Association of Allergology and Clinical Immunology, Department of Allergology and Clinical Immunology of the Kazakh National Medical University, Almaty, Kazakhstan
Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland
ALL-MED Medical Research Institute, Wrocław, Poland
Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Poltava State Medical University, Poltava, Ukraine
National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular Immunology, Moscow, Russia and Pirogov Russian National Research Medical University, Moscow, Russian Federation
Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
KYomed INNOV, Montpellier, France
Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium
Allergy Unit D Kalogeromitros, 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
IMSB, Medical Faculty, University at Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany
Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, Santa Maria della Speranza Hospital, Battipaglia, Italy
Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra and Institute of Immunology, Faculty of Medicine, University of Coimbra, and Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, Netherlands
Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
ENT Department, Dar Al Shifa Hospital- Salmiya, Salmiya, Kuwait
Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
Department of Pulmonary Medicine and Tuberculosis, University Hospital Brno, Brno, Czech Republic
Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã, Portugal
Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece and International Primary Care Respiratory Group IPCRG, Aberdeen, United Kingdom
Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania
Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
Nova Southeastern University, Fort Lauderdale, FL, United States
Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
Celal Bayar University, Department of Pulmonology, Manisa, Turkey
University Clinic of Respiratory and Allergic Diseases, Golnick, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
University Hospital Montpellier, Montpellier, France
MEDCIDS - Department of Community Medicine
CINTESIS – Center for Health Technology and Services Research
RISE – Health Research Network
Department of Health Research Methods
ISGlobal
IMIM (Hospital del Mar Medical Research Institute)
Universitat Pompeu Fabra (UPF)
CIBER Epidemiología y Salud Pública (CIBERESP)
Department of Otolaryngology
Medical Consulting Czarlewski
Rhinology Unit & Smell Clinic
Department of Otorhinolaryngology
ARIA
Department of Medical Sciences
Institute of Biomedical Sciences
Center of Excellence in Asthma and Allergy
Department of Otorhinolaryngology
University of Bari Medical School
Transylvania University Brasov
Department of Allergy and Immunology
Institute of Allergology
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Quality Use of Respiratory Medicine Group
Department of Biomedical Sciences
Personalized Medicine
Allergy Section
Serviço de Imunoalergologia
NOVA Medical School/Comprehensive Health Research Centre (CHRC)
Division of Allergy/Immunology
SOS Allergology and Clinical Immunology
School of Medicine
Department of Medicine and Health Research Methods
ENT Department
UCIBIO
Fundaçao ProAR
Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology
VIM Suresnes
Department of Computing Science
Department of Otorhinolaryngology
Department of Pulmonary Diseases
Skin and Allergy Hospital
Servicio de Alergia e Immunologia
President of Kazakhstan Association of Allergology and Clinical Immunology
Department of Clinical Immunology
ALL-MED Medical Research Institute
Division of Internal Medicine
Poltava State Medical University
National Research Center
Department of Otorhinolaryngology
KYomed INNOV
Scottish Centre for Respiratory Research
Department of Pulmonary Medicine
Allergy Unit D Kalogeromitros
Department of Cardiovascular and Thoracic Sciences
Allergy Center
IMSB
Department of Allergology
Allergy Department
Division of Allergy and Clinical Immunology
Ecole Polytechnique Palaiseau
Allergy and Clinical Immunology Unit
Department of Otorhinolaryngology
Department of Otolaryngology-Head and Neck Surgery
ENT Department
Department of Prevention of Environmental Hazards
Usher Institute
Department of Pulmonary Medicine and Tuberculosis
Imunoalergologia
Faculty of Health Sciences
UBIAir - Clinical & Experimental Lung Centre
Department of Immunoallergology
Fundacion Jimenez Diaz
Health Planning Unit
Institute of Clinical Medicine and Institute of Health Sciences
Department of Chest Medicine
Nova Southeastern University
Department of Medicine
Celal Bayar University
University Clinic of Respiratory and Allergic Diseases
Faculty of Medicine
University Hospital Montpellier
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026