Effectiveness of AIT in RWD Analyses reflects Efficacy in
RCTs
Tables S5, S6, S7, S8 in supplementary information summarize detailed
results from the RWD analyses included. Taking a closer look at e.g. the
effects on progression of allergic rhinitis using grass pollen AIT (Tab.
S5), it is striking that the reduction in the use of antiallergic
medication in the different assessments ranges from 18.8% to 75%
compared to the non-AIT group. But comparing the results would be
misleading since the assessments differed substantially concerning e.g.
in-/exclusion criteria, matching process, evaluated antiallergic
medication or calculation/statistical methods, even when performed in
the same prescription database and nearly the same analysis periods.
Therefore, the results from different assessments do not indicate that
effectiveness is higher for any allergen (e.g. pollen vs. house dust
mites) or allergen preparation (e.g. SLIT vs. SCIT; allergoids vs.
unmodified preparations), especially since no direct comparisons between
single AIT preparations or preparation groups were made within the same
assessments.
In AIT RCTs, the primary endpoint is usually evaluated after one or two
years of treatment whereas one key advantage of RWD is the possibility
to evaluate data from longer observation periods. Despite this fact, we
tried to check consistency between RCT efficacy and RWD effectiveness by
using the medication scores from RCTs and the number of prescriptions in
RWD analyses for preparations, which could be unambiguously identified
in the RCT and RWD publications. For some preparations symptom
medication (SMS) score data (47) or data on reduction of dose steps of
inhaled corticosteroids (48) served as efficacy results in the RCTs in
the absence of medication score data (see Table S 11 in supplementary
information). The analysis proved that the efficacy shown in gold
standard DBPC RCTs is rigorously confirmed in RWD over longer time
periods.