Congruence between international guidelines and mite specific immunotherapy prescribing practices

Area of Science:

• Allergy and Immunology
• Respiratory Medicine
• Clinical Practice Research

Background:

• Guidelines for allergic rhinitis (ARIA) and asthma (GINA) recommend allergen-specific immunotherapy (SIT).
• Limited real-world data exists on SIT prescription congruence with guidelines for patients with both rhinitis and asthma comorbidities.

Purpose of the Study:

• To evaluate the congruence between SIT recommendations and actual prescribing practices in patients with comorbid allergic rhinitis and asthma.
• To identify factors influencing SIT prescription in this patient population.

Main Methods:

• An observational, multicenter study involving 518 patients from 34 allergy centers in Italy.
• Data collected via questionnaires over four months, assessing eligibility and SIT prescription based on ARIA and GINA guidelines.

Main Results:

• SIT was prescribed in 49.6% of patients, with similar prescription rates across eligibility groups (not eligible, eligible for one disease, eligible for both).
• SIT prescription showed strong correlation with rhinitis severity (consistent with ARIA) but inconsistent association with asthma severity (deviating from GINA).
• Younger age was a key factor for SIT prescription in both single-disease and dual-disease eligible groups; worsening symptoms also influenced decisions in the single-disease group.

Conclusions:

• Rhinitis severity and younger age are primary drivers for SIT prescription in mite-allergic patients with comorbid rhinitis and asthma.
• SIT prescription practices demonstrated better congruence with ARIA rhinitis guidelines than GINA asthma guidelines.