Published paper from Sunjay Modi, M.D. et al on Allergen Immunotherapy for Allergic Rhinitis

The physicians at Asthma & Allergy Associates of Michigan are widely respected and published in their field. For example, in May 2023, Sunjay Modi, M.D. , et al (Matthew R Norris 2, Victoria Nguyen 3, Robert Bower 3, Timothy J Craig 2, Taha Al-Shaikhly 2) ) were published on the topic of “Racial and Ethnic Disparities in Allergen Immunotherapy Prescription for Allergic Rhinitis”.

Abstract

Background: Racial and ethnic differences exist in the severity of various atopic diseases including allergic rhinitis (AR). Patients of under-represented races and ethnicities may be subjected to disparate subcutaneous allergen immunotherapy (SCIT) prescription practices.

Objective: To explore the racial and ethnic disparities in the use of SCIT among patients with AR.

Methods: In this retrospective matched cohort study, we used the TriNetX US Collaborative Network, a multicenter electronic health record-based database to identify patients with AR 18 years and older. Patients were grouped according to their racial and ethnic identification. Study groups were matched for baseline demographics, atopic comorbidities, heart diseases and utilization of β-blockers, and angiotensin-converting enzyme inhibitors. The proportion of patients of under-represented racial and ethnic groups started on SCIT was contrasted to the non-Hispanic White cohort.

Results: We identified 1,038,000 patients with AR; the mean age (±standard deviation) at the index was 49.7 (±16.1) years, and 64.6% were female. Ethnicity information was available from 87.3% of patients, and the majority (92.3%) were non-Hispanic. Over a 3-year observation period, fewer Black patients (relative risk [RR], 0.40; 95% confidence interval [CI], 0.33-0.48) and Hispanic patients (RR, 0.80; 95% CI, 0.64-0.99) were started on SCIT compared with non-Hispanic White patients. The proportions of Asian patients who were initiated on SCIT tended to be lower when compared with non-Hispanic White patients (RR, 0.69; 95% CI, 0.47-1.009).

Conclusions: In the United States, differences in SCIT prescription exist between Black and Hispanic patients relative to White patients. Barriers to treatment should be explored and mitigated.

Keywords: AIT; Allergen immunotherapy; Allergic rhinitis; Disparities in health care; Ethnic disparities; Racial disparities; SCIT; Subcutaneous allergen immunotherapy.

Conflict of interest statement

Conflicts of interests: T. Al-Shaikhly has patents pending for MicroRNAs as Predictors of Response to Anti-IgE Therapies in Chronic Spontaneous Urticaria as well as for MicroRNAs in Methods of Treatment using Omalizumab and Legelizumab. T. Craig does research for Ionis, Takeda, CSL Behring, Pharvaris, Pfizer, GSK, Regeneron, Kalvista, BioMarin, and Biocryst. He speaks for Takeda, CSL Behring, Grifols and Regeneron. He consults for Takeda, CSL Behring, Biocryst, BioMarin, Incyte, and Spark. He is on the Medical Advisory Board for the US Hereditary Angioedema Association; Director of the Penn State University Angioedema ACARE Resource Center, and Alpha--antitrypsin Resource Center. All other authors have no conflicts of interest to disclose.