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Purpose <p>Allergic rhinitis (AR), which is prevalent among children and adolescents, often impairs quality of life and coexists with asthma. Allergen immunotherapy (AIT), particularly sublingual immunotherapy (SLIT), is recommended for individuals with insufficient response to standard treatments. While adherence is critical to AIT effectiveness, its impact on the use of allergy medications remains unclear. This study aimed to investigate the association between adherence to SLIT for grass pollen and use of prescription allergy medications.</p> Methods <p>A&#xa0;nationwide cohort study was conducted using Danish health registries. Children and adolescents initiating SLIT from 2007–2022 were classified as adherent (≥ 80% of defined daily dose [DDD]) or nonadherent (&lt; 1&#xa0;year of DDD). Individuals with intermediate adherence were excluded. Primary outcomes were annual use and dosage of prescription oral antihistamines, nasal corticosteroids, and inhaled corticosteroids, analyzed using two-step regression models adjusted for age and sex.</p> Results <p>Among 2500 children and adolescents, 1118 were adherent and 446 nonadherent. Over time, the adherent group showed a&#xa0;significant reduction in antihistamine and nasal corticosteroid use compared to the nonadherent group, relative to pretreatment levels (<i>p</i> &lt; 0.05). No significant difference in inhaled corticosteroid use was observed. Among users, mean annual doses of allergy medications were higher in the adherent group, likely reflecting broader adherence behaviors.</p> Conclusion <p>Adherence to SLIT was associated with reduced use of symptomatic allergy medications, highlighting its clinical importance. Strategies to improve adherence—such as patient education and structured follow-up—may enhance outcomes in pediatric AR management.</p>

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Adherence to grass pollen allergen immunotherapy and use of allergy medications in children and adolescents

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月3日

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  • Morten Borg,
  • Ole Hilberg,
  • Rikke Ibsen,
  • Anders Løkke

摘要

Purpose

Allergic rhinitis (AR), which is prevalent among children and adolescents, often impairs quality of life and coexists with asthma. Allergen immunotherapy (AIT), particularly sublingual immunotherapy (SLIT), is recommended for individuals with insufficient response to standard treatments. While adherence is critical to AIT effectiveness, its impact on the use of allergy medications remains unclear. This study aimed to investigate the association between adherence to SLIT for grass pollen and use of prescription allergy medications.

Methods

A nationwide cohort study was conducted using Danish health registries. Children and adolescents initiating SLIT from 2007–2022 were classified as adherent (≥ 80% of defined daily dose [DDD]) or nonadherent (< 1 year of DDD). Individuals with intermediate adherence were excluded. Primary outcomes were annual use and dosage of prescription oral antihistamines, nasal corticosteroids, and inhaled corticosteroids, analyzed using two-step regression models adjusted for age and sex.

Results

Among 2500 children and adolescents, 1118 were adherent and 446 nonadherent. Over time, the adherent group showed a significant reduction in antihistamine and nasal corticosteroid use compared to the nonadherent group, relative to pretreatment levels (p < 0.05). No significant difference in inhaled corticosteroid use was observed. Among users, mean annual doses of allergy medications were higher in the adherent group, likely reflecting broader adherence behaviors.

Conclusion

Adherence to SLIT was associated with reduced use of symptomatic allergy medications, highlighting its clinical importance. Strategies to improve adherence—such as patient education and structured follow-up—may enhance outcomes in pediatric AR management.