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Peer-reviewedCC BY 4.0Immunity, Inflammation and Disease

Allergen Immunotherapy and 36‐Month Allergic Respiratory Disease Trajectories: A Target‐Trial

  • Víctor Gonzalez‐Uribe1,2
  • Sebastian Moreno‐Castro1,2
  • Viviana Cardoso‐Perez1,2
  • Diego A Mares‐Mateos1,2
  • Mariel Paez‐Reyes1,2
  • Jimena Prieto‐Gomez1,2
  • Ricardo Martinez‐Tenopala1,2
  • Paola de Baro Alvarez1,2
  1. 1AlergiaMx Mexico City Mexico
  2. 2Facultad Mexicana de Medicina Universidad La Salle México Mexico City Mexico
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Abstract

Background: Allergen immunotherapy (AIT) may modify allergic respiratory disease, but its association with progression and remission in routine practice remains uncertain.

Materials and Methods: We emulated a target trial in a single‐center retrospective cohort at AlergiaMx, Mexico City, using data from 2020 to 2025. We compared sublingual allergen immunotherapy initiation within a 14‐day grace period with non‐initiation among AIT‐eligible patients. Follow‐up extended up to 36 months, and propensity‐score overlap weighting addressed baseline confounding.

Results: Among 2,713 patients, 1,971 initiated AIT and 742 did not. Weighted disease worsening was 46.3% versus 63.6% (relative risk [RR] 0.73, 95% confidence interval [CI] 0.65–0.82), and sustained progression was 8.4% versus 17.0% (RR 0.49, 95% CI 0.35–0.69). At 36 months, clinical remission was 47.0% versus 18.3% (RR 2.57, 95% CI 1.93–3.43), and treatment‐associated remission was 31.7% versus 5.8% (RR 5.44, 95% CI 3.23–9.16). Longitudinal differences favored AIT for asthma control, quality of life, and fractional exhaled nitric oxide.

Discussion: AIT initiation was associated with less worsening, greater remission, and favorable clinical and inflammatory trajectories over 36 months. These observational findings do not establish a causal disease‐modifying effect; residual confounding and differential follow‐up remain possible.

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Cite

BibTeXRIS
BibTeX
@article{gonzalezuribe2026allergen,
  title = {{Allergen Immunotherapy and 36‐Month Allergic Respiratory Disease Trajectories: A Target‐Trial}},
  author = {Víctor Gonzalez‐Uribe and Sebastian Moreno‐Castro and Viviana Cardoso‐Perez and Diego A Mares‐Mateos and Mariel Paez‐Reyes and Jimena Prieto‐Gomez and Ricardo Martinez‐Tenopala and Paola de Baro Alvarez},
  journal = {Immunity, Inflammation and Disease},
  year = {2026},
  month = oct,
  doi = {10.1002/iid3.70569},
  url = {https://doi.org/10.1002/iid3.70569},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Allergen Immunotherapy and 36‐Month Allergic Respiratory Disease Trajectories: A Target‐Trial
AU  - Víctor Gonzalez‐Uribe
AU  - Sebastian Moreno‐Castro
AU  - Viviana Cardoso‐Perez
AU  - Diego A Mares‐Mateos
AU  - Mariel Paez‐Reyes
AU  - Jimena Prieto‐Gomez
AU  - Ricardo Martinez‐Tenopala
AU  - Paola de Baro Alvarez
PY  - 2026
DA  - 2026/10/26
JO  - Immunity, Inflammation and Disease
DO  - 10.1002/iid3.70569
UR  - https://doi.org/10.1002/iid3.70569
AB  - Background: Allergen immunotherapy (AIT) may modify allergic respiratory disease, but its association with progression and remission in routine practice remains uncertain.  Materials and Methods: We emulated a target trial in a single‐center retrospective cohort at AlergiaMx, Mexico City, using data from 2020 to 2025. We compared sublingual allergen immunotherapy initiation within a 14‐day grace period with non‐initiation among AIT‐eligible patients. Follow‐up extended up to 36 months, and propensity‐score overlap weighting addressed baseline confounding.  Results: Among 2,713 patients, 1,971 initiated AIT and 742 did not. Weighted disease worsening was 46.3% versus 63.6% (relative risk [RR] 0.73, 95% confidence interval [CI] 0.65–0.82), and sustained progression was 8.4% versus 17.0% (RR 0.49, 95% CI 0.35–0.69). At 36 months, clinical remission was 47.0% versus 18.3% (RR 2.57, 95% CI 1.93–3.43), and treatment‐associated remission was 31.7% versus 5.8% (RR 5.44, 95% CI 3.23–9.16). Longitudinal differences favored AIT for asthma control, quality of life, and fractional exhaled nitric oxide.  Discussion: AIT initiation was associated with less worsening, greater remission, and favorable clinical and inflammatory trajectories over 36 months. These observational findings do not establish a causal disease‐modifying effect; residual confounding and differential follow‐up remain possible.
SN  - 2050-4527
ER  -