RACIAL AND ETHNIC DISPARITIES IN SUBCUTANEOUS ALLERGEN IMMUNOTHERAPY FOR PEDIATRIC PATIENTS WITH ALLERGIC RHINITIS

Introduction

Racial and ethnic disparities in treatment are commonly found across multiple atopic diseases. Herein, we explore discrepancies in initiation of subcutaneous allergen immunotherapy (SCIT) among various races and ethnicities of pediatric patients with allergic rhinitis.

Methods

In this retrospective matched cohort study, we utilized the TriNetX US Collaborative Network (TriNetX LLC, Cambridge, MA), a multicenter electronic health record database, to identify pediatric patients with allergic rhinitis (age 1-17 years). Patients were stratified into study groups according to their racial and ethnic identification. The study groups were further matched for baseline demographics, atopic comorbidities, heart diseases, and use of beta-blockers and angiotensin-converting enzyme inhibitors. Relative risk (RR) and Confidence Interval (CI) for SCIT initiation were contrasted across study groups.

Results

Among 544,360 pediatric patients with allergic rhinitis (mean age (± standard deviation) was 7.6 (4.5) years; % females, 46.9%), ethnicity data was available for 88.3% of patients with 79.7% identified as non-Hispanic. Over a 3-year observation period, fewer pediatric Black patients [RR, 0.30; 95% CI, 0.24-0.38)] were started on SCIT as compared to pediatric non-Hispanic White patients. Similarly, the proportion of Hispanic [RR, 0.46; 95% CI, 0.37-0.58)] and Asian [RR, 0.49; 95% CI, 0.30-0.81)] pediatric patients with allergic rhinitis who were initiated on SCIT were lower than their non-Hispanic White counterparts.

Conclusion

In the United States, racial and ethnic disparities in SCIT prescription extend to pediatric patients with allergic rhinitis with underutilization of SCIT among under-represented races and ethnicities in comparison to White patients. Barriers to treatment should be further explored and mitigated.