Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air® real-world data

Bernardo Sousa-Pinto, Ana Sá-Sousa, Rafael José Vieira, Rita Amaral, Ludger Klimek, Wienczyslawa Czarlewski, Josep M Antó, Oliver Pfaar, Anna Bedbrook, Violeta Kvedariene, Maria Teresa Ventura, Ignacio J Ansotegui, Karl-Christian Bergmann, Luisa Brussino, G Walter Canonica, Victoria Cardona, Pedro Carreiro-Martins, Tomas Casale, Lorenzo Cecchi, Tomás ChivatoDerek K Chu, Cemal Cingi, Elísio M Costa, Alvaro A Cruz, Giulia De Feo, Philippe Devillier, Wytske J Fokkens, Mina Gaga, Bilun Gemicioğlu, Tari Haahtela, Juan Carlos Ivancevich, Zhanat Ispayeva, Marek Jutel, Piotr Kuna, Igor Kaidashev, Helga Kraxner, Désirée E Larenas-Linnemann, Daniel Laune, Brian Lipworth, Renaud Louis, Michael Makris, Ricardo Monti, Mario Morais-Almeida, Ralph Mösges, Joaquim Mullol, Mikaëla Odemyr, Yoshitaka Okamoto, Nikolaos G Papadopoulos, Vincenzo Patella, Nhân Pham-Thi, Frederico S Regateiro, Sietze Reitsma, Philip W Rouadi, Boleslaw Samolinski, Milan Sova, Ana Todo-Bom, Luis Taborda-Barata, Peter Valentin Tomazic, Sanna Toppila-Salmi, Joaquin Sastre, Ioanna Tsiligianni, Arunas Valiulis, Olivier Vandenplas, Dana Wallace, Susan Waserman, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, João Almeida Fonseca, Jean Bousquet

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)
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BACKGROUND: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patterns in Europe, using real-world data.

METHODS: We analysed 2015-2020 MASK-air® European data. We compared days under no medication, monotherapy, and co-medication using the visual analogue scale (VAS) levels for overall allergic symptoms ("VAS Global Symptoms") and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported per patient within one year.

RESULTS: We analysed 222,024 days (13,122 users), including 63,887 days (28.8%) under monotherapy, and 38,315 (17.3%) under co-medication. The median "VAS Global Symptoms" was 7 for no medication days, 14 for monotherapy and 21 for co-medication (p<0.001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H1 -antihistamines were the most common medication in single and co-medication. Each patient reported using an annual average of 2.7 drugs, with 80% reporting two or more.

CONCLUSIONS: AR medication patterns are similar across European regions. One third of treatment days involved co-medication. These findings suggest that patients treat themselves according to their symptoms (irrespective of how they understand AR), and that co-medication use is driven by symptom severity.

Original languageEnglish
Pages (from-to)2699-2711
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number9
Early online date8 Mar 2022
Publication statusPublished - Sept 2022


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