Real-world use of sublingual immunotherapy and shared decisions in French observational study PRACTIS

• Key messages: What is already known about this topic? • SLIT is an effective treatment for allergic rhinitis, with/without asthma. It is available in tablet or liquid form with a wide variety of allergen extracts and dose flexibility, enabling treatment personalisation in clinical practice. • What does this article add to our knowledge? • The PRACTIS study describes the modalities of use of SLIT in France highlighting that patient involvement in SLIT choice and flexible formulations increase satisfaction, adherence, and willingness to continue treatment. • How does this study impact current guidelines • Guidelines may emphasize personalised treatment plans with SLIT, considering patient preferences and allergen profiles, to enhance adherence and treatment success. Allergic rhinitis (AR) with/without allergic asthma (AA) can be treated with sublingual allergen immunotherapy (SLIT). The PRACTIS study evaluated the short-term benefits of SLIT in AR patients in current practice in France. Here are specifically described the observed modalities of use and treatment plan. This prospective, non-interventional, longitudinal, multicentre study was conducted in patients ≥5-years-old, with clinically significant confirmed AR to one or more allergens and eligible for SLIT. Patients’ data were recorded at inclusion and after 6 (seasonal allergy) or 12 (perennial allergy) months of SLIT. SLIT was prescribed in 1587 patients (mean age 25.8 ± 15.6 years, 52.7% female) and 1047 (66.0%) attended the end-of-study visit to assess the benefits and satisfaction with SLIT. Most (87.4%) patients had moderate-to-severe persistent AR, 31.8% had AA and 50.8% were poly-allergic. The main reasons for prescribing SLIT were discomfort severity (85.4%) and type of allergic symptoms (80.2%). Patients were involved in the treatment choice in 68.7% of cases. A single SLIT was prescribed to 88.0% of patients, mainly in liquid form (71.8%), most frequently house dust mite or grass pollen allergen extracts. Physician-patient agreement on satisfaction with SLIT was >80% for mono-allergic and poly-allergic patients at end-of-study. Overall, 85.7% of patients planned to continue treatment and 78.8% would recommend SLIT to someone else. SLIT availability in tablet or liquid form, comprising a large number of allergen extracts and dose flexibility, enables treatment personalisation. The shared decision with the patients in the prescription type may improve SLIT adherence and satisfaction.