Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference

Bernardo Sousa-Pinto; Holger J. Schünemann; Ana Sá-Sousa; Rafael José Vieira; Rita Amaral; Josep M. Anto; Ludger Klimek; Wienczyslawa Czarlewski; Joaquim Mullol; Oliver Pfaar; Anna Bedbrook; Luisa Brussino; Violeta Kvedariene; Desirée Larenas-Linnemann; Yoshitaka Okamoto; Maria Teresa Ventura; Ioana Agache; Ignacio J. Ansotegui; Karl C. Bergmann; Sinthia Bosnic-Anticevich; Jan Brozek; G. Walter Canonica; Victoria Cardona; Pedro Carreiro-Martins; Thomas Casale; Lorenzo Cecchi; Tomas Chivato; Derek K. Chu; Cemal Cingi; Elísio M. Costa; Alvaro A. Cruz; Stefano del Giacco; Philippe Devillier; Patrik Eklund; Wytske J. Fokkens; Bilun Gemicioglu; Tari Haahtela; Juan Carlos Ivancevich; Zhanat Ispayeva; Marek Jutel; Piotr Kuna; Igor Kaidashev; Musa Khaitov; Helga Kraxner; Daniel Laune; Brian Lipworth; Renaud Louis; Michael Makris; Riccardo Monti; Mario Morais-Almeida; Ralph Mösges; Marek Niedoszytko; Nikolaos G. Papadopoulos; Vincenzo Patella; Nhân Pham-Thi; Frederico S. Regateiro; Sietze Reitsma; Philip W. Rouadi; Boleslaw Samolinski; Aziz Sheikh; Milan Sova; Ana Todo-Bom; Luis Taborda-Barata; Sanna Toppila-Salmi; Joaquin Sastre; Ioanna Tsiligianni; Arunas Valiulis; Olivier Vandenplas; Dana Wallace; Susan Waserman; Arzu Yorgancioglu; Mihaela Zidarn; Torsten Zuberbier; Joao A. Fonseca; Jean Bousquet

doi:https://doi.org/10.1111/all.15371

Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference

Bernardo Sousa-Pinto, Holger J. Schünemann, Ana Sá-Sousa, Rafael José Vieira, Rita Amaral, Josep M. Anto, Ludger Klimek, Wienczyslawa Czarlewski, Joaquim Mullol, Oliver Pfaar, Anna Bedbrook, Luisa Brussino, Violeta Kvedariene, Desirée Larenas-Linnemann, Yoshitaka Okamoto, Maria Teresa Ventura, Ioana Agache, Ignacio J. Ansotegui, Karl C. Bergmann, Sinthia Bosnic-AnticevichJan Brozek, G. Walter Canonica, Victoria Cardona, Pedro Carreiro-Martins, Thomas Casale, Lorenzo Cecchi, Tomas Chivato, Derek K. Chu, Cemal Cingi, Elísio M. Costa, Alvaro A. Cruz, Stefano del Giacco, Philippe Devillier, Patrik Eklund, Wytske J. Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Zhanat Ispayeva, Marek Jutel, Piotr Kuna, Igor Kaidashev, Musa Khaitov, Helga Kraxner, Daniel Laune, Brian Lipworth, Renaud Louis, Michael Makris, Riccardo Monti, Mario Morais-Almeida, Ralph Mösges, Marek Niedoszytko, Nikolaos G. Papadopoulos, Vincenzo Patella, Nhân Pham-Thi, Frederico S. Regateiro, Sietze Reitsma, Philip W. Rouadi, Boleslaw Samolinski, Aziz Sheikh, Milan Sova, Ana Todo-Bom, Luis Taborda-Barata, Sanna Toppila-Salmi, Joaquin Sastre, Ioanna Tsiligianni, Arunas Valiulis, Olivier Vandenplas, Dana Wallace, Susan Waserman, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, Joao A. Fonseca, Jean Bousquet

Research output: Contribution to journal › Article › Academic › peer-review

9 Citations (Scopus)

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”). 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.

Original language	English
Pages (from-to)	3002-3014
Number of pages	13
Journal	Allergy: European Journal of Allergy and Clinical Immunology
Volume	77
Issue number	10
Early online date	2022
DOIs	https://doi.org/10.1111/all.15371
Publication status	Published - Oct 2022

Keywords

allergen immunotherapy
allergic rhinitis
co-medication
multivariable mixed-effects model
real-world data

Access to Document

https://doi.org/10.1111/all.15371

Cite this

Sousa-Pinto, B., Schünemann, H. J., Sá-Sousa, A., Vieira, RJ., 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, IJ., Bergmann, K. C., ... Bousquet, J. (2022). Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference. Allergy: European Journal of Allergy and Clinical Immunology, 77(10), 3002-3014. https://doi.org/10.1111/all.15371

@article{4eef271fe7a24920ba5c03c3c20a9ff0,

title = "Comparison of rhinitis treatments using MASK-air{\textregistered} data and considering the minimal important difference",

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”). 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{\textregistered} 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.",

keywords = "allergen immunotherapy, allergic rhinitis, co-medication, multivariable mixed-effects model, real-world data",

author = "Bernardo Sousa-Pinto and Sch{\"u}nemann, {Holger J.} and Ana S{\'a}-Sousa and Rafael Jos{\'e} Vieira and Rita Amaral and Anto, {Josep M.} and Ludger Klimek and Wienczyslawa Czarlewski and Joaquim Mullol and Oliver Pfaar and Anna Bedbrook and Luisa Brussino and Violeta Kvedariene and Desir{\'e}e Larenas-Linnemann and Yoshitaka Okamoto and Ventura, {Maria Teresa} and Ioana Agache and Ignacio J. Ansotegui and Bergmann, {Karl C.} and Sinthia Bosnic-Anticevich and Jan Brozek and Canonica, {G. Walter} and Victoria Cardona and Pedro Carreiro-Martins and Thomas Casale and Lorenzo Cecchi and Tomas Chivato and Chu, {Derek K.} and Cemal Cingi and Costa, {El{\'i}sio M.} and Cruz, {Alvaro A.} and {del Giacco}, Stefano and Philippe Devillier and Patrik Eklund and Fokkens, {Wytske J.} and Bilun Gemicioglu and Tari Haahtela and Ivancevich, {Juan Carlos} and Zhanat Ispayeva and Marek Jutel and Piotr Kuna and Igor Kaidashev and Musa Khaitov and Helga Kraxner and Daniel Laune and Brian Lipworth and Renaud Louis and Michael Makris and Riccardo Monti and Mario Morais-Almeida and Ralph M{\"o}sges and Marek Niedoszytko and Papadopoulos, {Nikolaos G.} and Vincenzo Patella and Nh{\^a}n Pham-Thi and Regateiro, {Frederico S.} and Sietze Reitsma and Rouadi, {Philip W.} and Boleslaw Samolinski and Aziz Sheikh and Milan Sova and Ana Todo-Bom and Luis Taborda-Barata and Sanna Toppila-Salmi and Joaquin Sastre and Ioanna Tsiligianni and Arunas Valiulis and Olivier Vandenplas and Dana Wallace and Susan Waserman and Arzu Yorgancioglu and Mihaela Zidarn and Torsten Zuberbier and Fonseca, {Joao A.} and Jean Bousquet",

note = "Funding Information: IA reports personal fees from Roxall, Menarini, UCB, Faes Farma, Sanofi, Bial, Amgen, Abbott, Bayer, Organon. SBA reports grants from TEVA, personal fees from TEVA, AstraZeneca, Boehringer Ingelheim, GSK, Sanofi, Mylan. JB reports personal fees from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Sanofi‐Aventis, Takeda, Teva, Uriach, other from KYomed‐Innov, personal fees from Purina, other from MASK‐air. VC reports personal fees from Thermofisher. PCM reports personal fees from Abbvie, AZ, Bial, GSK, Mylan, Medinfar, Novartis, Sanofi. LC reports personal fees from Malesci, Menarini, Astra Zeneca, Novartis. AC reports grants and personal fees from Astrazeneca, GSK, Sanofi, personal fees from Boehringer‐Ingelheim, Chiesi, Glenmark, Novartis, personal fees from Mylan, Abdi‐Ibrahim. PD reports personal fees and non‐financial support from Stallergenes Greer, ALK‐Abello, Astra Zeneca, CHIESI, MYLAN/Meda Pharma, Novartis, GlaxoSmithKline, Sanofi, IQVIA personal fees from MENARINI. JAFonseca reports participation in SME that has mHealth technologies for patients with asthma. JCI reports personal fees from Abbott Ecuador, Bago Bolivia, Faes Farma, Laboratorios Casasco, Sanofi. LK reports grants and personal fees from Allergopharma, LETI Pharma,MEDA/Mylan, Sanofi, personal fees from HAL Allergie, Allergy Therapeut., Cassella med, grants from ALK Abell{\'o}, Stallergenes, Quintiles, ASIT biotech, Lofarma, AstraZeneca, GSK, Inmunotk, and Membership: AeDA, DGHNO, Deutsche Akademie f{\"u}r Allergologie und klinische Immunologie, HNO‐BV, GPA, EAACI. VK reports other from Norameda, BerlinCHemie Menarini. PK reports personal fees from Adamed, AstraZeneca, Berlin Chemie Menarini, Boehringer Ingelheim, Chiesi, GSK, Novartis, Polpharma. DLL reports personal fees from Allakos, Amstrong, Astrazeneca, Chiesi, DBV Technologies, Grunenthal, GSK, Mylan/Viatris, Menarini, MSD, Novartis, Pfizer, Sanofi, Siegfried, UCB, Alakos, Gossamer, Carnot, grants from Sanofi, Astrazeneca, Novartis, Circassia, UCB, GSK, Purina institute, Abvvie, Lilly, Pfizer. BL reports grants and personal fees from Meda, personal fees from Glenamrk. RL reports grants and personal fees from GSK, AZ, Chiesi, personal fees from Novartis, Sanofi. MM reports personal fees from Novartis, Gsk, Menarini, Az, Chiesi, Sanofi, Pfizer. RM reports personal fees from Angelini Pharma ALK, Allergopharma, Allergy Therapeutics, Friulchem, Hexal, Servier, Klosterfrau, Bayer, FAES, GSK, MSD, Johnson&Johnson, Meda, Stada, UCB, Nuvo, Menarini, Mundipharma, Pohl‐Boskamp, Laboratoire de la Mer, Sidroga, Lek, PRO‐AdWise, grants and personal fees from Bencard, Stallergenes, Ursapharm, HAL BV, grants from Leti, Optima, BitopAG, Hulka, Inmunotek, Cassella‐med GmbH & Co. KG, ASIT biotech, grants, personal fees and non‐financial support from Lofarma, non‐financial support from Roxall, Atmos, Bionorica, Otonomy, Ferrero, personal fees and non‐financial support from Novartis. OP reports grants and personal fees from ALK‐Abell{\'o}, Allergopharma, Stallergenes Greer HAL Allergy Holding B.V./HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools S.A., Laboratorios LETI/LETI Pharma, Anergis S.A., GlaxoSmithKline, personal fees from MEDA Pharma/MYLAN, Mobile Chamber Experts (a GA2LEN Partner), Indoor Biotechnologies, Astellas Pharma Global, EUFOREA, ROXALL Medizin, Novartis, Sanofi‐Aventis and Sanofi‐Genzyme, Med Update Europe GmbH, streamedup! GmbH, John Wiley and Sons, AS, Paul‐Martini‐Stiftung (PMS), Regeneron Pharmaceuticals Inc., RG Aerztefortbildung, Institut f{\"u}r Disease Management, Springer GmbH, AstraZeneca, IQVIA Commercial, Ingress Health, grants from Pohl‐Boskamp, Inmunotek S.L., Biomay, Circassia. NGPapadopoulos reports personal fees from Novartis, Nutricia, HAL, MENARINI/FAES FARMA, SANOFI, MYLAN/MEDA, BIOMAY, AstraZeneca, GSK, MSD, ASIT BIOTECH, Boehringer Ingelheim, grants from Gerolymatos International SA, Capricare. ATB reports personal fees from AstraZeneca, GSK, Novartis, IQVIA/Abbvie, Mylan, Bial, Leti, grants and personal fees from Teva. STS reports personal fees from ERT, Roche products, Novartis, Sanofi Pharma, AstraZeneca, ALK‐ Abell{\'o} grants from Glaxo Smith Kline. IT reports grants from GSK, Boehringer Ingelheim, AZ, personal fees from Novartis, Astra Zeneca, Chiesi, TZ reports Organizational affiliations: Committee member: WHO‐Initiative “Allergic Rhinitis and Its Impact on Asthma” (ARIA); Member of the Board: German Society for Allergy and Clinical Immunology (DGAKI); Head: European Centre for Allergy Research Foundation (ECARF). President: Global Allergy and Asthma European Network (GA2LEN); Member: Committee on Allergy Diagnosis and Molecular Allergology, World Allergy Organization (WAO). Funding Information: MASK‐air{\textregistered} has been supported by EU grants (POLLAR, EIT Health; Structural and Development Funds, Twinning, EIP on AHA and H2020) and educational grants from Mylan‐Viatris, ALK, GSK, Novartis and Uriach 1 1 Publisher Copyright: {\textcopyright} 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",

year = "2022",

month = oct,

doi = "https://doi.org/10.1111/all.15371",

language = "English",

volume = "77",

pages = "3002--3014",

journal = "Allergy: European Journal of Allergy and Clinical Immunology",

issn = "0105-4538",

publisher = "Wiley-Blackwell",

number = "10",

}

Sousa-Pinto, B, Schünemann, HJ, Sá-Sousa, A, Vieira, RJ, Amaral, R, Anto, JM, Klimek, L, Czarlewski, W, Mullol, J, Pfaar, O, Bedbrook, A, Brussino, L, Kvedariene, V, Larenas-Linnemann, D, Okamoto, Y, Ventura, MT, Agache, I, Ansotegui, IJ, Bergmann, KC, Bosnic-Anticevich, S, Brozek, J, Canonica, GW, Cardona, V, Carreiro-Martins, P, Casale, T, Cecchi, L, Chivato, T, Chu, DK, Cingi, C, Costa, EM, Cruz, AA, del Giacco, S, Devillier, P, Eklund, P, Fokkens, WJ, Gemicioglu, B, Haahtela, T, Ivancevich, JC, 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, NG, Patella, V, Pham-Thi, N, Regateiro, FS, Reitsma, S, Rouadi, PW, 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, JA & Bousquet, J 2022, 'Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference', Allergy: European Journal of Allergy and Clinical Immunology, vol. 77, no. 10, pp. 3002-3014. https://doi.org/10.1111/all.15371

TY - JOUR

T1 - Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference

AU - Sousa-Pinto, Bernardo

AU - Schünemann, Holger J.

AU - Sá-Sousa, Ana

AU - Vieira, Rafael José

AU - Amaral, Rita

AU - Anto, Josep M.

AU - Klimek, Ludger

AU - Czarlewski, Wienczyslawa

AU - Mullol, Joaquim

AU - Pfaar, Oliver

AU - Bedbrook, Anna

AU - Brussino, Luisa

AU - Kvedariene, Violeta

AU - Larenas-Linnemann, Desirée

AU - Okamoto, Yoshitaka

AU - Ventura, Maria Teresa

AU - Agache, Ioana

AU - Ansotegui, Ignacio J.

AU - Bergmann, Karl C.

AU - Bosnic-Anticevich, Sinthia

AU - Brozek, Jan

AU - Canonica, G. Walter

AU - Cardona, Victoria

AU - Carreiro-Martins, Pedro

AU - Casale, Thomas

AU - Cecchi, Lorenzo

AU - Chivato, Tomas

AU - Chu, Derek K.

AU - Cingi, Cemal

AU - Costa, Elísio M.

AU - Cruz, Alvaro A.

AU - del Giacco, Stefano

AU - Devillier, Philippe

AU - Eklund, Patrik

AU - Fokkens, Wytske J.

AU - Gemicioglu, Bilun

AU - Haahtela, Tari

AU - Ivancevich, Juan Carlos

AU - Ispayeva, Zhanat

AU - Jutel, Marek

AU - Kuna, Piotr

AU - Kaidashev, Igor

AU - Khaitov, Musa

AU - Kraxner, Helga

AU - Laune, Daniel

AU - Lipworth, Brian

AU - Louis, Renaud

AU - Makris, Michael

AU - Monti, Riccardo

AU - Morais-Almeida, Mario

AU - Mösges, Ralph

AU - Niedoszytko, Marek

AU - Papadopoulos, Nikolaos G.

AU - Patella, Vincenzo

AU - Pham-Thi, Nhân

AU - Regateiro, Frederico S.

AU - Reitsma, Sietze

AU - Rouadi, Philip W.

AU - Samolinski, Boleslaw

AU - Sheikh, Aziz

AU - Sova, Milan

AU - Todo-Bom, Ana

AU - Taborda-Barata, Luis

AU - Toppila-Salmi, Sanna

AU - Sastre, Joaquin

AU - Tsiligianni, Ioanna

AU - Valiulis, Arunas

AU - Vandenplas, Olivier

AU - Wallace, Dana

AU - Waserman, Susan

AU - Yorgancioglu, Arzu

AU - Zidarn, Mihaela

AU - Zuberbier, Torsten

AU - Fonseca, Joao A.

AU - Bousquet, Jean

N1 - Funding Information: IA reports personal fees from Roxall, Menarini, UCB, Faes Farma, Sanofi, Bial, Amgen, Abbott, Bayer, Organon. SBA reports grants from TEVA, personal fees from TEVA, AstraZeneca, Boehringer Ingelheim, GSK, Sanofi, Mylan. JB reports personal fees from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Sanofi‐Aventis, Takeda, Teva, Uriach, other from KYomed‐Innov, personal fees from Purina, other from MASK‐air. VC reports personal fees from Thermofisher. PCM reports personal fees from Abbvie, AZ, Bial, GSK, Mylan, Medinfar, Novartis, Sanofi. LC reports personal fees from Malesci, Menarini, Astra Zeneca, Novartis. AC reports grants and personal fees from Astrazeneca, GSK, Sanofi, personal fees from Boehringer‐Ingelheim, Chiesi, Glenmark, Novartis, personal fees from Mylan, Abdi‐Ibrahim. PD reports personal fees and non‐financial support from Stallergenes Greer, ALK‐Abello, Astra Zeneca, CHIESI, MYLAN/Meda Pharma, Novartis, GlaxoSmithKline, Sanofi, IQVIA personal fees from MENARINI. JAFonseca reports participation in SME that has mHealth technologies for patients with asthma. JCI reports personal fees from Abbott Ecuador, Bago Bolivia, Faes Farma, Laboratorios Casasco, Sanofi. LK reports grants and personal fees from Allergopharma, LETI Pharma,MEDA/Mylan, Sanofi, personal fees from HAL Allergie, Allergy Therapeut., Cassella med, grants from ALK Abelló, Stallergenes, Quintiles, ASIT biotech, Lofarma, AstraZeneca, GSK, Inmunotk, and Membership: AeDA, DGHNO, Deutsche Akademie für Allergologie und klinische Immunologie, HNO‐BV, GPA, EAACI. VK reports other from Norameda, BerlinCHemie Menarini. PK reports personal fees from Adamed, AstraZeneca, Berlin Chemie Menarini, Boehringer Ingelheim, Chiesi, GSK, Novartis, Polpharma. DLL reports personal fees from Allakos, Amstrong, Astrazeneca, Chiesi, DBV Technologies, Grunenthal, GSK, Mylan/Viatris, Menarini, MSD, Novartis, Pfizer, Sanofi, Siegfried, UCB, Alakos, Gossamer, Carnot, grants from Sanofi, Astrazeneca, Novartis, Circassia, UCB, GSK, Purina institute, Abvvie, Lilly, Pfizer. BL reports grants and personal fees from Meda, personal fees from Glenamrk. RL reports grants and personal fees from GSK, AZ, Chiesi, personal fees from Novartis, Sanofi. MM reports personal fees from Novartis, Gsk, Menarini, Az, Chiesi, Sanofi, Pfizer. RM reports personal fees from Angelini Pharma ALK, Allergopharma, Allergy Therapeutics, Friulchem, Hexal, Servier, Klosterfrau, Bayer, FAES, GSK, MSD, Johnson&Johnson, Meda, Stada, UCB, Nuvo, Menarini, Mundipharma, Pohl‐Boskamp, Laboratoire de la Mer, Sidroga, Lek, PRO‐AdWise, grants and personal fees from Bencard, Stallergenes, Ursapharm, HAL BV, grants from Leti, Optima, BitopAG, Hulka, Inmunotek, Cassella‐med GmbH & Co. KG, ASIT biotech, grants, personal fees and non‐financial support from Lofarma, non‐financial support from Roxall, Atmos, Bionorica, Otonomy, Ferrero, personal fees and non‐financial support from Novartis. OP reports grants and personal fees from ALK‐Abelló, Allergopharma, Stallergenes Greer HAL Allergy Holding B.V./HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools S.A., Laboratorios LETI/LETI Pharma, Anergis S.A., GlaxoSmithKline, personal fees from MEDA Pharma/MYLAN, Mobile Chamber Experts (a GA2LEN Partner), Indoor Biotechnologies, Astellas Pharma Global, EUFOREA, ROXALL Medizin, Novartis, Sanofi‐Aventis and Sanofi‐Genzyme, Med Update Europe GmbH, streamedup! GmbH, John Wiley and Sons, AS, Paul‐Martini‐Stiftung (PMS), Regeneron Pharmaceuticals Inc., RG Aerztefortbildung, Institut für Disease Management, Springer GmbH, AstraZeneca, IQVIA Commercial, Ingress Health, grants from Pohl‐Boskamp, Inmunotek S.L., Biomay, Circassia. NGPapadopoulos reports personal fees from Novartis, Nutricia, HAL, MENARINI/FAES FARMA, SANOFI, MYLAN/MEDA, BIOMAY, AstraZeneca, GSK, MSD, ASIT BIOTECH, Boehringer Ingelheim, grants from Gerolymatos International SA, Capricare. ATB reports personal fees from AstraZeneca, GSK, Novartis, IQVIA/Abbvie, Mylan, Bial, Leti, grants and personal fees from Teva. STS reports personal fees from ERT, Roche products, Novartis, Sanofi Pharma, AstraZeneca, ALK‐ Abelló grants from Glaxo Smith Kline. IT reports grants from GSK, Boehringer Ingelheim, AZ, personal fees from Novartis, Astra Zeneca, Chiesi, TZ reports Organizational affiliations: Committee member: WHO‐Initiative “Allergic Rhinitis and Its Impact on Asthma” (ARIA); Member of the Board: German Society for Allergy and Clinical Immunology (DGAKI); Head: European Centre for Allergy Research Foundation (ECARF). President: Global Allergy and Asthma European Network (GA2LEN); Member: Committee on Allergy Diagnosis and Molecular Allergology, World Allergy Organization (WAO). Funding Information: MASK‐air® has been supported by EU grants (POLLAR, EIT Health; Structural and Development Funds, Twinning, EIP on AHA and H2020) and educational grants from Mylan‐Viatris, ALK, GSK, Novartis and Uriach 1 1 Publisher Copyright: © 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2022/10

Y1 - 2022/10

N2 - 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.

AB - 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.

KW - allergen immunotherapy

KW - allergic rhinitis

KW - co-medication

KW - multivariable mixed-effects model

KW - real-world data

UR - http://www.scopus.com/inward/record.url?scp=85131752144&partnerID=8YFLogxK

U2 - https://doi.org/10.1111/all.15371

DO - https://doi.org/10.1111/all.15371

M3 - Article

C2 - 35567393

SN - 0105-4538

VL - 77

SP - 3002

EP - 3014

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

IS - 10

ER -

Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference

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