Abstract
Allergologie select, Vol. 7/2023 (47-56)
Real-life evidence in allergen immunotherapy: Moving forward with mHealth apps
Bernardo Sousa-Pinto1,2,3, Oliver Pfaar4, and Jean Bousquet5,6,7
1MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, 2CINTESIS, Center for Health Technology and Services Research, 3RISE, Health Research Network, University of Porto, Porto, Portugal, 4Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, 5Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 6Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany, and 7University Hospital Montpellier, Montpellier, France
Aim: The efficacy and safety of allergen immunotherapy (AIT) in allergic rhinitis has been classically assessed using randomized controlled trials (RCTs). However, RCTs may have limitations in their external validity, and their evidence may be complemented with that from real-world studies. We aimed to review the mHealth apps that can be used for retrieving real-world data on AIT in allergic rhinitis. Materials and methods: We applied an automatic tool to identify the mHealth apps (available in the Google Play and Apple App stores) that can be used to assess patients under AIT for allergic rhinitis. Apps meeting the inclusion criteria were reviewed, and the corresponding scientific evidence was assessed. Results: We identified five apps with scientific publications in the context of allergic rhinitis: AirRater, AllergyMonitor, MASK-air, Husteblume, and Pollen App. Of those, only MASK-air and AllergyMonitor assessed AIT in patients with allergic rhinitis. MASK-air has enabled the comparison of reported symptoms among patients treated vs. not-treated with AIT. MASK-air has also allowed for the development of combined symptom-medication scores that can be used as endpoints for AIT trials. AllergyMonitor has identified that mobile technology can improve adherence to AIT and is set to support the prescription of AIT for patients with allergic rhinitis by a more precise identification of the pollen season. Conclusion: Mobile health tools allow for the collection of large volumes of real-world data and can be useful for generating hypotheses on AIT. However, such hypotheses require confirmation by epidemiological studies and RCTs.Correspondence to:
Jean Bousquet, Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Hindenburgdamm 30 (Geländeadresse, Haus II), 12200 Berlin, Germany
Email: [email protected]
Abstract
Allergologie select, Vol. 8/2024 (270-277)
Protocol for the systematic reviews on the desirable and undesirable effects of pharmacological treatments of allergic rhinitis informing the ARIA 2024 guidelines
Rafael José Vieira1,2, Maria Inês Torres1,2, Antonio Bognanni3,4, Sara Gil-Mata1,2, Renato Ferreira-da-Silva1,2, Nuno Lourenço-Silva1,2, António Cardoso-Fernandes1,2, André Ferreira2,5,6, Henrique Ferreira-Cardoso1,2, João Teles1,2, Miguel Campos-Lopes1,2, João A. Fonseca1,2, Juan José Yepes-Nuñez3,7, Ludger Klimek8,9, Torsten Zuberbier10,11, Holger Schünemann3, Jean Bousquet10,11,12, and Bernardo Sousa-Pinto1,2
1MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, 2CINTESIS@RISE – Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal, 3Department of Health Research Methods, Evidence and Impact, 4Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, ON, Canada, 5Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, 6Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal, 7School of Medicine, Universidad de los Andes, Bogotá, Colombia, 8Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, 9Center for Rhinology and Allergology, Wiesbaden, 10Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 11Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany, and 12ARIA, Montpellier, France
There is insufficient evidence regarding the comparative efficacy and safety of pharmacological treatments of allergic rhinitis (AR). In the context of informing the 2024 revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, we plan to perform three systematic reviews of randomized controlled trials (RCTs) comparing the desirable and undesirable effects (i) between intranasal and oral medications for AR; (ii) between combinations of intranasal and oral medications versus nasal or oral medications alone; and (iii) among different intranasal specific medications. We will search four electronic bibliographic databases and three clinical trials databases for RCTs examining patients ≥ 12 years old with seasonal or perennial AR. Assessed outcomes will include the Total Nasal Symptom Score, the Total Ocular Symptom Score, and the Rhinoconjunctivitis Quality-of-Life Questionnaire. We will assess the methodological quality of included primary studies by using the Cochrane risk-of-bias tool. If appropriate, we will perform a pairwise random-effects meta-analysis for each pair of assessed medication classes and outcomes, as well as a network meta-analysis to assess the comparative efficacy of intranasal medications among each other. Heterogeneity will be explored by sensitivity and subgroup analyses. This set of systematic reviews will allow for a comprehensive assessment of the effectiveness and safety of pharmacological interventions for AR and inform recommendations in the context of the ARIA guidelines.Correspondence to:
Professor Jean Bousquet, Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Email: [email protected]
