Author/Editor     Sousa-Pinto, Bernardo; Schünemann, Holger J.; Sá-Sousa, Ana; Vieira, Rafael José; Amaral, Rita; Antò i Boquè, Josep M.; Klimek, Ludger; Czarlewski, Wienczyslawa; Mullol, Joaquim; Pfaar, Oliver; Bedbrook, Anna; Zidarn, Mihaela; Fonseca, Joao A.; Bousquet, Jean
Title     Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference
Type     članek
Vol. and No.     Letnik 77, št. 10
Publication year     2022
Volume     str. 3002-3014
ISSN     1398-9995 - Allergy
Language     eng
Abstract     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”). Objective: To compare AR pharmacological treatments on (i) daily symptoms, (ii) frequency of use in co-medication, (iii) visual analogue scale (VAS) 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 patient, and controlling for confounding factors. We compared (i) allergy symptoms between patients with and without AIT and (ii) different drug classes used in comedication. 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 chances of being used in co-medication (adjusted OR=0.75; 95%CI=0.71-0.80). Conclusions: 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.
Descriptors     Asthma
Rhinitis
Rhinitis, allergic
Desensitization, immunologic
Visual analogue scale
Histamine antagonists
Astma
Rinitis
Alergijski rinitis
Imunološka desenzibilizacija
Vizualna analogna lestvica
Histaminski antagonisti
Drug therapy
Drug therapy
Drug therapy
Terapija z zdravili
Terapija z zdravili
Terapija z zdravili
Keywords     antihistamines
allergen immunotherapy
real-world data
antihistaminiki
specifična imunoterapija
podatki iz resničnega življenja