The British Society for Allergy and Clinical Immunology Registry for Immunotherapy (BRIT) has published its first report documenting its findings here Launched in October 2018, this online national registry collects data from patients receiving allergen immunotherapy to aeroallergens and venom, as well as omalizumab for chronic urticaria, to the end of describing treatments and services as well as monitoring safety and clinical effectiveness.
The UK has fewer allergy specialists than any other developed country which has led to an unmet need in specialist care. Due to the restriction around public funding of immunotherapy, most specialist centres manage only a handful of patients, one consequence of this is that it is difficult to gain sufficient numbers to draw meaningful conclusions about safety and effectiveness of treatment or to benchmark personal practice against national trends. The BSACI Registry for Immunotherapy (BRIT) provides an important service for both patients and healthcare professionals by collecting data on the real-world use of specialist treatments. This data can be used in a range of settings, with the potential to transform standards of care and save lives.
Dr Mich Lajeunesse, registry lead: “BSACI Registry for Immunotherapy provides an essential service, this report increases our knowledge and understanding of specialist allergy and immunology treatments in the UK. The number of people in the UK who suffer from severe allergies is steadily increasing, yet as a nation we have limited funding and a paucity of specialists in the area. Allergy can be life threatening; at the BSACI we are advancing our knowledge to enable us to provide resources for specialists and improve allergy management in the UK.”
Currently, over 20% of the UK population suffer from some form of allergic disorder and the condition is becoming more prevalent.(1) Since the 1970’s, three times the number of children receive treatment for asthma, hay fever and eczema, of which almost half have at least two co-existing conditions.(2) 5.4 million people in the UK currently receive treatment for asthma (3), around 7% of children suffer from food allergies (4) and as many as 40% from allergic rhinitis (hay fever)(5). At the current rate, the European Academy of Allergy and Clinical Immunology, EAACI have predicted that around half of the entire EU population will be affected by some form of allergy by 2025 (6).
The First Registry for Immunotherapy report
provides a snapshot of the first 18 months from a data pool of 580 participants from England, 96% of whom agreed to email contact with the registry to return quality of life data, during and after treatment.
• 455 were receiving aeroallergen allergen immunotherapy for seasonal and perennial allergic rhinitis with grass pollen, tree pollen and dust mite the most common allergens treated. 99% had prior allergy testing to confirm the allergens used for treatment.
• Sublingual immunotherapy was the preferred route in 84% of AIT recipients.
• Asthma is a relative contraindication for AIT. 160 / 455 had asthma with 31% treated at BTS step 3 or above.
• Of 50 stopped AIT courses, adverse events were responsible for 5 (10%) and poor adherence for another 4 (8%). The overall adverse event rate for AIT was 20 / 455, 4.4% with only one episode of anaphylaxis reported.
• 103 received venom immunotherapy with wasp more common than bee by a ratio of 2:1, the majority for moderate or severe allergic reactions to stings.
• There were 23 field stings reported to the registry during VIT and 273 no sting reports. Only one reported an allergic reaction to a field sting but did not require adrenaline.
• 20 were registered for omalizumab treatment for Chronic Spontaneous Urticaria. In keeping with NICE guidelines all had received high dose H1 antihistamine before treatment.
The Anaphylaxis Campaign is a member of the BRIT Steering Group