The moderating role of allergy immunotherapy in asthma
progression: Results of a population‐based cohort study
Professor: Hans Jürgen Hoffmann
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Background: Allergic asthma causes substantial morbidity and constitutes a publichealth burden, which increases with asthma severity. There is evidence that allergyimmunotherapy (AIT) prevents the progression of allergic rhinitis (AR) to asthma.However, evidence is missing on the potential of AIT to prevent progression frommilder to more severe asthma.
Methods: This population‐based cohort study utilized healthcare data (2005 to 2014)from a statutory health insurance in Germany. The severity of asthma was classifiedaccording to the treatment steps recommended by the global initiative for asthma(GINA). The effect of AIT on the transition between the GINA steps was analyzedusing multivariable Cox regression models adjusted for age and sex.
Results: From the total cohort of 1,739,440 patients, 39,167 individuals aged 14 yearsor older were classified as having incident asthma during the observation period andwere included in the study. From these, 4111 patients (10.5%) received AIT. AIT exposurewas associated with a significantly decreased likelihood of asthma progressionfrom GINA step 1 to GINA step 3 (HR 0.87; 95% CI 0.80‐0.95) and GINA step 3 toGINA step 4 (HR 0.66; 95% CI 0.60‐0.74). GINA medication for step 2 and step 5 wasrarely prescribed.Conclusions: This observational study in a real‐world setting indicates that patientswith allergic asthma who receive AIT are less likely to experience progression ofasthma severity than asthma patients not receiving AIT.
Conclusions: NHF may constitute an alternative to NIV in COPD patients with stablechronic hypercapnia, eg, those not tolerating or rejecting NIV with respect to pCO2 reductionand improvement in QoL.