title: Characteristics of patients with respiratory allergy in France and factors influencing immunotherapy prescription: a prospective observational study (REALIS).
abstract: To describe the sensitization profile of respiratory allergies in France, identifying factors influencing the prescription of allergen immunotherapy (AIT) [Transversal phase (T)], and assess treatment efficacy, tolerability, compliance and satisfaction [Longitudinal phase (L)]. French allergists (600) and pneumo-allergists (600) were offered participation and asked to recruit the first 20 new patients with allergic rhinitis (AR) and/or asthma, consulting for a first time allergy check-up with skin prick-test (T), and 5 patients sensitized to pollens (skin test and/or specific IgE) for whom SLIT with pollens was prescribed (L). In the T phase, 2,714 patients were recruited by 169 specialists, mostly allergists (76.5%). The majority (98%) suffered from AR, alone (57.7%) or with asthma (40.3%) and 80.3% suffered from moderate-to-severe rhinitis, mostly persistent (65.8%). Asthma, when present, was mostly intermittent (63.7%) or mild persistent (20.1%). Sensitization to house dust mites was the most common (64.5%), followed by grass pollens (61.5%), tree pollens (41.6%) and cat danders (30.5%). Poly-sensitization was seen in 73.6% of patients. AIT, mostly sublingual, was recommended in 55.6% of the patients, mostly (78.1%) because of insufficient control with symptomatic treatments. The overall impact of symptoms on QOL, positive skin test to grass pollens, ocular pruritus and/or nasal obstruction and moderate-to-severe rhinitis were significant predictors of SLIT prescription. Poly-sensitization or concomitant asthma were not seen as deterrents. Most patients consulting a specialist for allergy testing suffer from moderate-to-severe rhinitis. Treatment in current practice includes immunotherapy in half of the patients, and follows ARIA recommendations.
authors.affiliation: Clinique de l'Union, Saint-Jean, Toulouse, France. michel.migueres@clinique-union.fr
authors.forename: M
authors.initials: M
authors.lastname: Migueres
authors.forename: J-F
authors.initials: JF
authors.lastname: Fontaine
authors.forename: T
authors.initials: T
authors.lastname: Haddad
authors.forename: M
authors.initials: M
authors.lastname: Grosclaude
authors.forename: F
authors.initials: F
authors.lastname: Saint-Martin
authors.forename: D
authors.initials: D
authors.lastname: Bem David
authors.forename: B
authors.initials: B
authors.lastname: Crestani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000941:Antigens / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000009:adverse effects; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D012720:Severity of Illness Index; D012882:Skin Tests; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000941:Antigens