Résumé
Background: The real-world EfficAPSI study aimed at evaluating the impact of sublingual liquid immunotherapy (SLIT) in allergic rhinitis (AR) patients, primarily on asthma onset or worsening 1 and, as a secondary objective, on healthcare resource utilisation (HCRU). Here we present data on oral corticosteroid (OCS) sparing.Method: This cohort analysis using inverse probability of treatment weighting from the French National Health Data System “SNDS” paired to Stallergenes Greer SLIT dispensation database compared patients dispensed SLIT vs. control (AR treatment and no history of allergen immunotherapy (AIT)). Patients included between 2010 and 2013 were followed up until 2018. Five periods were analysed: historical pre-SLIT period (HP, i.e. 2 years before index date of the first dispensing of SLIT or AR treatment) and four 2-year follow-up periods (FUP) from index date. As SLIT distribution was temporarily suspended in 2015, the 2 last FUPs were considered post-treatment periods, thus patients received treatment for up to 5 years. HCRU was analysed in all patients and by pre-existing asthma status using a Poisson model with generalised estimating equations and 2 indicators of change: change between HP and each of the FUPs within each group and between-group difference in change from HP to each FUP.Results: Of the 99,538 SLIT and 333,082 control patients included, around half had at least one OCS dispensing (47.0% and 57.2%, respectively). The mean number of OCS packs dispensed over the HP was similar between groups (SLIT = 1.3, Control = 1.5; Table). During follow-up, OCS dispensing significantly decreased in SLIT group (by 10–15%) and increased in control group (by 2–20%). The difference in change from HP was in favour of SLIT for all FUPs, ranging from −14% to −26% vs. control. Compared with those without pre-existing asthma, patients with asthma were dispensed more OCS with a significant reduction during follow-up vs. HP in both SLIT and control groups (no differences for SLIT and increase for control in not asthmatic patients). On the other hand, in both subsets, between-group results were significantly in favour of SLIT.Conclusion: In this real-world study with the largest patient number and follow-up in the field of AIT to date, treatment with SLIT in AR ± asthma patients was associated with OCS sparing (−14% to −26% vs. control). Observed results in the 2 last post-treatment FUPs suggest a sustained effect of SLIT in patients treated for 2–5 years.