The SIMAP projects had the following objectives: 
-To study the management of the two groups of patients (with asthma and with allergic rhinitis) with particular focus on the use of sublingual immunotherapy 
-To study the tolerability of sublingual desensitization immunotherapy 
-To study the resources used by patients with asthma or allergic rhinitis 

It is a prospective cohort study in which 6 Italian centres have part-taken. It is composed of a first phase lasting 3 months(February – April 2004) in which all patients were enrolled (adults and children) who presented to the centres involved with the above mentioned pathologies and who consented to take part in the study. A second phase (May 2004- June 2005) was of follow up. 

For each recruited patient data was collected about clinical and theraputic aspects at every consultation. A minimum contact of one consultation every 3 months was set. Patients were also given a diary in which to annotate significant data between consultations. 

All data obtained was registered in an electronic file (Allergywork) created by Società Servizi Telematici di Padova. They were then sent in anonymously by internet to a central server, within the same company where they were then validated and sent to Dr. Patrizia Berto of PBE Consulting for analysis. 

382 patients were enrolled (196 males and 186 females average age 28 years ± 13 years). Of these 197 had allergic rhinitis (AR) and 38 (10%) only asthma (AA), while 147 had both. 
immunotherapy (IT) was prescribed to 247 (65%) patients (238 sublingual e 13 subcutaneous), while 135 pazienti (35%) were treated with standard therapy. 
The average number of consultations per patient were 1.7 and 909 drugs were prescribed during the study. 38% of these drugs were antihistamines, 25% inhaled corticosteroids, 15% LABA+steroids and 10% leukotrienes. A total of 4833 laboratory tests were ordered (average of 12.2 per patient). Of these 97% were allergy testing and 3% spirometry. 
The results of this study show how asthma and allergic rhinitis have an important impact on public health, both in terms of workmload as well as resources.

Partecipants and Collaborations


Patrizia Berto 
PBE consulting, Verona 
Franco Frati 
Stallergenes scientific Department 
Luigi Cantarutti 
Coordinamento Pedianet, PLS, Padova


Mario Di Gioacchino, Nicola Verna. 
Ospedale clinicizzato “Colle dell’Ara”. Università di Chieti. Chieti 

Rosario Contiguglia, Carla Magazzù 
Centro “Progetto Respiro”. Messina 

Carla Valle 
Ospedale “ San Paolo”, Università di Milano 

Marco Bassi 
ASL “G. Salvini”, ospedale di Rho (Mi) 

Gianni Cadario, Fulvia Marengo 
Struttura complessa immunologia, allergologia clinica. ASL San Giovanni Battista, Torino 

Maria Angiola Crivellaro, Michele Schiappoli 
Ospedale Borgo Trento, Verona


Data Monitor

Antonio Scamarcia 
Società Servizi Telematici, Padova

Computer-related Assistance

Alessandro Zandarin 
Società Servizi Telematici, Padova


Berto P, Bassi M, Incorvaia C, Frati F, Puccinelli P, Giaquinto C, Cantarutti L, Ortolani C.

Cost effectiveness of sublingual immunotherapy in children with allergic rhinitis and asthma.

Allerg Immunol (Paris) 2005, 37: 3030-308

Berto P, Bassi M, Cadario G et al

Immunotherapy and access to medical care in patients with allergic rhinitis and asthma. The SIMAP database study.

25 Congress of the European Academy of Allergology and clinical immunology, Vienna June 2006, Abstract N° 789


This study was funded by Stallergenes spa