Laird Harrison

March 05, 2014

SAN DIEGO — People who get immunotherapy injections for their allergies are less likely to develop infectious diseases such as chronic pharyngitis, nasopharyngitis, sinusitis, diseases of the tonsils and adenoids, and the flu, a new study shows.

"Allergic rhinitis is a precursor to the allergic march toward asthma and other respiratory disease," said lead investigator Cheryl Hankin, PhD, president and chief scientific officer of BioMedEcon in Moss Beach, California.

However, "after allergy immunotherapy, significantly fewer patients sought out treatment for chronic infections of the upper respiratory tract," she reported.

Dr. Hankin presented the results during a news conference here at the American Academy of Allergy, Asthma & Immunology 2014.

To measure the impact of immunotherapy on other respiratory diseases, Dr. Hankin and her team examined data on retirees living in Florida who were enrolled in Medicaid. They matched 4967 patients who received immunotherapy to 4967 who did not. Demographic characteristics and health conditions, including allergies, were similar in the immunotherapy and control groups.

Patients in the immunotherapy group received allergy shots over a period of 18 months. The proportion of these patients receiving outpatient care for chronic upper respiratory infection at the end of that period dropped 24.6% (< .0001), whereas in the control group, the proportion of patients who got this care dropped only 14.3% (= .0005).

Fewer Polyps, Less Flu

Patients in the immunotherapy group experienced a significantly greater reduction in the use of outpatient care for nasal polyps, influenza, allergic reactions, and emphysema.

This research expands on findings from a previous 10-year study conducted by Dr. Hankin and her team that compared healthcare costs in 2 groups of children with newly diagnosed allergic rhinitis — those who received allergy immunotherapy and those who did not (Ann Allergy Asthma Immunol. 2010;104:79-85).

Within 3 months of treatment initiation, children in the immunotherapy group incurred significantly lower overall, outpatient, and pharmacy costs than those in the control group.

Both these studies provide evidence supporting the expansion of immunotherapy, said Dr. Hankin. "Only about 3% to 9% of patients with allergic rhinitis actually receive immunotherapy. If we aggressively treat all those patients appropriately for allergy, immunotherapy could prevent high-cost ailments like chronic sinusitis."

She called for more education on the benefits of immunotherapy for patients.

Dr. Hankin acknowledged, however, that immunotherapy by injection is a difficult regimen, and said she is hoping that sublingual therapies now being developed will increase the number of people who receive treatment.

Although these studies are worthwhile, they fall short of proving that immunotherapy can prevent other conditions, said Jessica Savage, MD, from Harvard Medical School in Cambridge, Massachusetts.

Without randomly assigning patients to receive immunotherapy or not, it is difficult to know whether the 2 groups are truly identical, she told Medscape Medical News.

"People who are healthier and have their lives together are more likely to pursue treatments," she said. "Immunotherapy is a huge time investment so there is selection bias in who gets it."

Patients able to follow through with that investment might also be more likely to get other preventive care and be more compliant with other healthcare directions from their providers, she said.

Dr. Hankin is president of BioMedEcon, whose clients include many pharmaceutical companies. Dr. Savage has disclosed no relevant financial relationships.

American Academy of Allergy, Asthma & Immunology (AAAAI) 2014: Abstract 579. Presented March 1, 2014.

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