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Background  Allergy immunotherapy ( AIT ) is the only treatment for allergic rhinitis ( AR ) and/or allergic asthma ( AA ) with long‐term efficacy. However, there are few real‐life data on the progression of  AR  and/or  AA  in patients receiving  AIT .    Objectives  To assess the real‐world, long‐term efficacy of grass pollen sublingual immunotherapy ( SLIT ) tablets in  AR  and their impact on asthma onset and progression.    Methods  In a retrospective analysis of a German longitudinal prescription database,  AR  patients treated with grass pollen  SLIT  tablets were compared with a control group not having received  AIT . Multiple regression analysis was used to compare changes over time in rescue symptomatic  AR  medication use after treatment cessation, asthma medication use, and the time to asthma onset in the two groups.    Results  After applying all selection criteria, 2851  SLIT  and 71 275 control patients were selected for the study. After treatment cessation,  AR  medication use was 18.8 percentage points lower (after adjustment for covariates, and relative to the pretreatment period) in  SLIT  tablet group than in the non‐ AIT  group ( P <.001). Asthma onset was less frequent in  SLIT  tablet group than in non‐ AIT  group (odds ratio: 0.696,  P =.002), and time to asthma was significantly longer (hazard ratio: 0.523;  P =.003). After  SLIT  cessation, asthma medication use fell by an additional 16.7 percentage points (relative to the pretreatment period) in the  SLIT  tablet group vs the non‐ AIT  group ( P =.004).    Conclusions  Real‐world treatment of  AR  patients with grass pollen  SLIT  tablets was associated with slower  AR  progression, less frequent asthma onset, and slower asthma progression.

Sublingual immunotherapy provides long‐term relief in allergic rhinitis and reduces the risk of asthma: A retrospective, real‐world database analysis