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Background  Real‐world evidence is sparse on the benefits of allergen immunotherapy [ AIT ; subcutaneous/sublingual immunotherapy ( SCIT / SLIT )], the only disease‐modifying intervention for allergic rhinitis ( AR ) with long‐term efficacy. This real‐life study evaluated the effect of six  AIT s (native pollen  SLIT / SCIT , four allergoid  SCIT s) vs symptomatic medication use, on  AR  symptoms and asthma symptoms/onset, in patients with birch pollen‐associated  AR  and/or asthma.    Methods  In this retrospective cohort analysis of a German longitudinal prescription database,  AIT  patients received ≥2 successive seasonal treatment cycles; non‐ AIT  patients had ≥3 AR prescriptions in three seasons or previous month. Patients were matched for: index year, age, gender, main indication at index, number of seasonal cycles within treatment period, baseline  AR /asthma treatment prescriptions. Multiple regression analysis compared prescription data in  AIT  and non‐ AIT  groups as proxy for clinical status/disease progression.    Results  Up to 6 years of follow‐up, significantly more  AIT  (65.4%) vs non‐ AIT  (47.4%) patients were  AR  medication‐free; odds ratio ( OR ) [95% confidence interval ( CI )]: 0.51 [(0.48‐0.54);  P  < 0.001] (28.6% covariate‐adjusted reduction vs non‐ AIT ;  P  < 0.001), and significantly more  AIT  (49.1%) vs non‐ AIT  (35.1%) patients were asthma medication‐free [ OR  (95%  CI ): 0.59 (0.55‐0.65);  P  < 0.001] (32% reduction vs non‐ AIT ;  P  < 0.001), or reduced existing asthma medication use (32% covariate‐adjusted reduction vs non‐ AIT ;  P  < 0.001). During treatment, new‐onset asthma risk was significantly reduced in the  AIT  vs non‐ AIT  group ( OR : 0.83;  P  = 0.001).    Conclusions  Birch pollen  AIT  demonstrated real‐world benefits up to 6 years post‐treatment cessation through significantly reduced  AR  and asthma medication intake, and significantly decreased risk of new‐onset asthma medication use on‐treatment.

Real‐world benefits of allergen immunotherapy for birch pollen‐associated allergic rhinitis and asthma