World Allergy Organization Journal (Jun 2023)

CHOICE international survey: Clusters of allergen immunotherapy prescription from French and Spanish cohorts

  • Pablo Rodriguez del Rio, MD, PhD,
  • Davide Caimmi, MD, PhD,
  • Pilar Rico Nieto, MD, PhD,
  • Carmen Vidal, MD, PhD,
  • Carmen Moreno, MD, PhD,
  • Maria Teresa González-Fernández, MD,
  • Margarita Tomás-Pérez, MD,
  • Ana Beristain, MD,
  • Isa Bosse, MD,
  • Hoai Bich Trinh, MD,
  • Thomas B. Casale, MD, PhD,
  • Pascal Demoly, MD, PhD,
  • Moises A. Calderon, MD, PhD

Journal volume & issue
Vol. 16, no. 6
p. 100791

Abstract

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Background: There is no description of the drivers of prescription for allergen immunotherapy (AIT) for respiratory allergic diseases. Methods: A prospective, multicentre, observational, non-interventional real-life study was performed in France and Spain for 20 months. Data were gathered using 2 different questionnaires, anonymously collected in an online platform. No names of AIT products were recorded. Multivariate analysis and unsupervised cluster analysis were performed. Results: One hundred and three physicians (50.5% from Spain and 49.5% from France) reported 1735 patients (433 in France and 1302 in Spain), 47.9% males, 64.8% adults with a mean age 26.2 years old. They suffered from allergic rhinitis (99%), allergic conjunctivitis (70.4%), allergic asthma (51.8%), atopic dermatitis (13.9%), and food allergy (9.9%). A clustering analysis based on 13 predefined relevant variables for AIT-prescription identified 5 different clusters, each of them including information regarding doctor's profile and patient demographics, baseline disease characteristics, and main AIT indication: 1) Looking at the future: focusing on asthma prevention (n = 355), 2) Efficacy after discontinuation of AIT (n = 293), 3) Fighting severe allergic disease (n = 322), 4) Looking at the present, facing current symptoms (n = 265) and 5) Doctor's own clinical experience (n = 500). Each one of these clusters have specific patients' and doctors' characteristics, representing distinctive AIT prescription drivers. Conclusion: Using data-driven analysis, we identified for the first time some reasons and patterns of AIT prescriptions in real-life clinical settings. There is no uniform indication for prescribing AIT, which varies amongst patients and doctors with multiple but specific drivers, taking into account several relevant parameters.

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