Quelles modalités de traitement par immunothérapie allergénique sublinguale en France pour des patients atteints de rhinoconjonctivite allergique liée aux graminées – étude Diagram

Abstract

IntroductionAllergen sublingual immunotherapy (SLIT) may be prescribed according to pre-co-seasonal or perennial treatment schedules. The DIAGRAM study describes French prescribing practices and the factors associated with the choice of one or other of these treatment plans. MethodologyCross-sectional observational study conducted between October 2018 and February 2020 including patients ≥5years with grass pollen allergic rhinoconjunctivitis (ARC) and initiating SLIT. On initiation of the SLIT, a retrospective symptom frequency score (RSFS) scored the 6 symptoms on a scale of 0 to 3 for the eyes and nose (total possible score 0 to 18) and patient discomfort reported by the investigator on a Visual Analogic Scale (VAS) ranging from 0 to 10. Comparisons between the two modalities were performed using statistical tests. ResultsData from a total of 1,119 patients (mean age 27 years, 54.4% of men) were analysed. The majority of patients (70.8%) had persistent severe ARC. The SLIT was prescribed on a perennial basis for 8% of patients and as pre-co-seasonal treatment for 92% of patients. The patients on a perennial treatment schedule had more concomitant asthma (39% vs 27%; P<0.01). They had a higher RSFS (67% vs 58% with an RSFS scored [13–18]; P<0.01) and their mean discomfort level score was also higher (8 vs 7.5; P<0.01). Among the reasons given for choosing the treatment plan, the desire to improve symptoms was greater in the perennial schedule group (50% vs 27% in the pre-co-seasonal group). ConclusionAlthough the pre-co-seasonal prescribing schedule was chosen for the majority of patients, the perennial schedule appeared to be preferred for the patients with the most severe symptoms.