{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:34Z","timestamp":1787027074901,"version":"build-2736575974"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Respiratory allergy, commonly manifesting as allergic rhinitis (AR) and asthma, is a chronic progressive disease that frequently starts in childhood. Allergy immunotherapy (AIT) is the only causal treatment for respiratory allergy with the potential to modify the underlying cause of allergy and, ultimately, prevent disease progression. This analysis aimed to determine if AIT is received sufficiently early to halt the progression of allergic disease, by characterizing the burden and progression of disease in children prior to AIT initiation in real-life clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The REAl-world effeCtiveness in allergy immunoTherapy (REACT) study was a large retrospective cohort study using German claims data between 2007 and 2017. Characteristics of two pre-defined AIT age cohorts from the REACT study \u2013 children (aged &amp;lt;18 years) and adults (aged \u226518 years) \u2013 were evaluated during the 1-year period before the first AIT prescription. For comparison, a control group of all subjects with a confirmed diagnosis of AR and without prescriptions for AIT was included. Burden of disease was assessed using diagnostic codes for atopic comorbidities [e.g., atopic dermatitis (AD), asthma, and acute allergic conjunctivitis] and non-atopic comorbidities (e.g., migraine, headache); medication use, recorded as prescriptions for symptom-relieving AR medication and reliever\/controller medication for asthma, was also assessed. Data were analyzed descriptively, using summary statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both children (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911,036) and adults (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930,037) showed a higher prevalence of atopic comorbidities and a greater drug burden prior to AIT initiation compared to AR patients not treated with AIT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,003,332). In the two age-specific AIT cohorts, children consistently showed the highest prevalence of atopic comorbidities compared to adults (AIT children, AIT adults \u2013 asthma: 41.4%, 34.5%; AD: 19.9%, 10.2%; acute allergic conjunctivitis: 13.6%, 10.2%). Generally, prescriptions per year for symptom-relieving AR and asthma treatments were also higher for children initiating AIT vs. adults (AIT children, AIT adults \u2013 AR prescriptions per subject: 1.72, 0.73; asthma prescriptions per subject: 1.42, 0.79).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children with AR who are offered AIT in real-life show considerable disease burden prior to initiation. As AIT may alleviate the burden and halt the progression of allergic disease, considering AIT earlier in the disease course may be warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2023.1136942","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T01:48:23Z","timestamp":1679968103000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["High baseline prevalence of atopic comorbidities and medication use in children treated with allergy immunotherapy in the REAl-world effeCtiveness in allergy immunoTherapy (REACT) study"],"prefix":"10.3389","volume":"11","author":[{"given":"Benedikt","family":"Fritszching","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Porsbjerg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Buchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie Rask","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Freemantle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Contoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"B1","volume-title":"EFA Book on respiratory allergies \u2013 raise awareness, relieve the burden","author":"Valovirta","year":""},{"key":"B2","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/S0140-6736(06)69283-0","article-title":"Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases One and Three repeat multicountry cross-sectional surveys","volume":"368","author":"Asher","year":"2006","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1111\/all.14046","article-title":"Allergic rhinitis and allergic sensitisation are still increasing among danish adults","volume":"75","author":"Leth-M\u00f8ller","year":"2020","journal-title":"Allergy"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1111\/all.13773","article-title":"The change in the prevalence of wheeze, eczema and rhino-conjunctivitis among Japanese children: findings from 3 nationwide cross-sectional surveys between 2005 and 2015","volume":"74","author":"Sasaki","year":"2019","journal-title":"Allergy"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e13656","DOI":"10.1111\/pai.13656","article-title":"Worldwide time trends in prevalence of symptoms of rhinoconjunctivitis in children: Global Asthma Network Phase I","volume":"33","author":"Strachan","year":"2022","journal-title":"Pediatr Allergy Immunol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1016\/j.jaci.2012.06.026","article-title":"Sleep and allergic disease: a summary of the literature and future directions for research","volume":"130","author":"Koinis-Mitchell","year":"2012","journal-title":"J Allergy Clin Immunol"},{"key":"B7","volume-title":"Pediatric asthma","author":"Lizzo","year":"2022"},{"key":"B8","doi-asserted-by":"publisher","first-page":"450","DOI":"10.3390\/children9040450","article-title":"New directions in understanding atopic march starting from atopic dermatitis","volume":"9","author":"Maiello","year":"2022","journal-title":"Children (Basel)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1016\/j.jaci.2007.07.020","article-title":"Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: a longitudinal study","volume":"120","author":"Burgess","year":"2007","journal-title":"J Allergy Clin Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1111\/all.15108","article-title":"Increasing severity of early-onset atopic dermatitis, but not late-onset, associates with development of aeroallergen sensitization and allergic rhinitis in childhood","volume":"77","author":"Schoos","year":"2022","journal-title":"Allergy"},{"key":"B11","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1471-5945-12-11","article-title":"Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort","volume":"12","author":"von Kobyletzki","year":"2012","journal-title":"BMC Dermatol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/j.1398-9995.2007.01620.x","article-title":"World Health Organization; GA2LEN; AllerGen. 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