Sublingual Immunotherapy for Allergic Rhinitissystematic Review and Meta-analysis

Review

. 2010 Dec 8;2010(12):CD002893.

doi: 10.1002/14651858.CD002893.pub2.

Sublingual immunotherapy for allergic rhinitis

Affiliations

  • PMID: 21154351
  • PMCID: PMC7001038
  • DOI: 10.1002/14651858.CD002893.pub2

Free PMC article

Review

Sublingual immunotherapy for allergic rhinitis

Suzana Radulovic  et al. Cochrane Database Syst Rev. .

Gratis PMC article

Abstruse

Background: This is an update of a Cochrane Review first published in The Cochrane Library in Event 2, 2003.Allergic rhinitis is a mutual condition which can significantly impair quality of life. Immunotherapy by injection can significantly reduce symptoms and medication utilise merely its apply is limited by the possibility of severe systemic adverse reactions. Immunotherapy by the sublingual route is therefore of considerable interest.

Objectives: To evaluate the efficacy and safety of sublingual immunotherapy for allergic rhinitis in adults and children.

Search strategy: We searched the Cochrane ENT Grouping Trials Annals; CENTRAL (2010, Issue 3); PubMed; EMBASE; CINAHL; Spider web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and boosted sources for published and unpublished trials. The date of the most recent search was fourteen August 2009.

Option criteria: Randomised, double-blind, placebo-controlled trials of sublingual immunotherapy in adults or children. Primary outcome measures were symptom and medication scores. We too collected adverse event data.

Information collection and assay: Two contained authors selected studies and assessed hazard of bias. I author extracted data which was rechecked by 2 other authors. We used the standardised mean difference (SMD) with a random-effects model to combine data.

Main results: We included a total of threescore randomised controlled trials in the review. Xl-9 were suitable for pooling in meta-analyses (2333 SLIT, 2256 placebo participants). Overall, nosotros found a meaning reduction in symptoms (SMD -0.49; 95% conviction interval (CI) -0.64 to -0.34, P < 0.00001) and medication requirements (SMD -0.32; 95% CI -0.43 to -0.21, P < 0.00001) in participants receiving sublingual immunotherapy compared to placebo. None of the trials included in this review reported severe systemic reactions or anaphylaxis, and none of the systemic reactions reported required the use of adrenaline.

Authors' conclusions: This updated review reinforces the determination of the original 2003 Cochrane Review that sublingual immunotherapy is effective for allergic rhinitis and has been proven to exist a safe route of administration.

Conflict of interest statement

The lead review writer, Dr Suzana Radulovic, has received financial support from the ITN (Immune Tolerance Network) equally an employee of the Paediatric Allergy Inquiry Department at Male monarch's College London, Britain.

The Section of Upper Respiratory Medicine, National Middle & Lung Institute, London, United kingdom of great britain and northern ireland, headed by Professor Durham, has received fiscal support from ALK Abello, Horsholm, Denmark ‐ manufacturers of allergen extracts. Stephen Durham has received consultancy and lecture fees and enquiry grants from Alk Abello, a manufacturer of allergy vaccines, via Imperial College.

There are no other conflicts of interest to be declared.

Figures

1
1

Risk of bias summary: review authors' judgements almost each take a chance of bias item for each included study.

2
2

Adventure of bias graph: review authors' judgements near each hazard of bias item presented as percentages beyond all included studies.

3
three

Funnel plot of comparing: one SLIT versus placebo ‐ all, outcome: 1.1 Allergic rhinitis symptom scores.

4
4

Funnel plot of comparing: 1 SLIT versus placebo ‐ all, outcome: ane.2 Medication scores.

1.1
ane.1. Analysis

Comparison ane SLIT versus placebo ‐ all, Outcome 1 Allergic rhinitis symptom scores.

1.2
1.2. Analysis

Comparing 1 SLIT versus placebo ‐ all, Outcome 2 Medication scores.

2.1
2.i. Analysis

Comparison 2 SLIT versus placebo ‐ seasonal allergen, Outcome 1 Allergic rhinitis symptom scores.

2.2
ii.2. Analysis

Comparing 2 SLIT versus placebo ‐ seasonal allergen, Consequence 2 Medication scores.

3.1
three.1. Analysis

Comparison 3 SLIT versus placebo ‐ perennial allergen, Event 1 Allergic rhinitis symptom scores.

3.2
3.2. Assay

Comparison 3 SLIT versus placebo ‐ perennial allergen, Outcome 2 Medication scores.

4.1
4.1. Analysis

Comparing iv SLIT versus placebo ‐ adults, Outcome 1 Allergic rhinitis symptom scores.

4.2
iv.2. Analysis

Comparison 4 SLIT versus placebo ‐ adults, Outcome ii Medication scores.

5.1
5.1. Analysis

Comparing five SLIT versus placebo ‐ children, Outcome ane Allergic rhinitis symptom scores.

5.2
5.2. Analysis

Comparison v SLIT versus placebo ‐ children, Outcome ii Medication scores.

6.1
6.1. Analysis

Comparison 6 SLIT versus placebo < 6 months, Consequence one Allergic rhinitis symptom scores.

6.2
six.2. Assay

Comparison 6 SLIT versus placebo < 6 months, Result 2 Medication scores.

7.1
7.i. Analysis

Comparison vii SLIT versus placebo half-dozen to 12 months, Upshot 1 Allergic rhinitis symptom scores.

7.2
7.2. Analysis

Comparison seven SLIT versus placebo 6 to 12 months, Outcome 2 Medication scores.

8.1
8.1. Analysis

Comparison 8 SLIT versus placebo > 12 months, Issue 1 Allergic rhinitis symptom scores.

8.2
8.ii. Analysis

Comparison 8 SLIT versus placebo > 12 months, Result ii Medication scores.

9.1
9.ane. Analysis

Comparison 9 Major allergen content < 5 mcg, Outcome 1 Allergic rhinitis symptom scores.

9.2
9.2. Assay

Comparison 9 Major allergen content < 5 mcg, Event 2 Medication scores.

10.1
10.1. Analysis

Comparison 10 Major allergen content 5 to twenty mcg, Effect ane Allergic rhinitis symptom scores.

10.2
10.2. Analysis

Comparison ten Major allergen content 5 to 20 mcg, Outcome two Medication scores.

11.1
xi.one. Analysis

Comparing xi Major allergen content > 20 mcg, Upshot one Allergic rhinitis symptom scores.

11.2
11.2. Analysis

Comparing 11 Major allergen content > 20 mcg, Result 2 Medication scores.

12.1
12.1. Analysis

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome one IgE levels ‐ post‐treatment.

12.2
12.ii. Analysis

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Issue 2 IgG levels ‐ post‐treatment.

12.3
12.three. Analysis

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 3 IgG4 levels‐ mail‐treatment.

13.1
13.one. Analysis

Comparison xiii SLIT v placebo ‐ firm dust mite, Upshot 1 Allergic rhinitis symptom scores.

13.2
13.2. Analysis

Comparison 13 SLIT v placebo ‐ house grit mite, Issue 2 Medication scores.

14.1
14.1. Analysis

Comparing xiv SLIT versus placebo ‐ grass pollen, Outcome 1 Allergic rhinitis symptom scores.

14.2
fourteen.two. Analysis

Comparing 14 SLIT versus placebo ‐ grass pollen, Outcome 2 Medication scores.

15.1
xv.1. Analysis

Comparison 15 SLIT versus placebo ‐ ragweed, Result 1 Allergic rhinitis symptom scores.

15.2
fifteen.2. Analysis

Comparison 15 SLIT versus placebo ‐ ragweed, Upshot 2 Medication scores.

16.1
16.1. Analysis

Comparison sixteen SLIT versus placebo ‐ Parietaria, Outcome ane Allergic rhinitis symptom scores.

16.2
xvi.2. Assay

Comparison xvi SLIT versus placebo ‐ Parietaria, Outcome 2 Medication scores.

17.1
17.1. Analysis

Comparison 17 SLIT versus placebo ‐ tree, Outcome i Allergic rhinitis symptom scores.

17.2
17.two. Analysis

Comparison 17 SLIT versus placebo ‐ tree, Issue ii Medication scores.

18.1
18.1. Analysis

Comparing xviii Allergen sensitivity, Effect 1 Skin reactivity subsequently treatment.

18.2
18.2. Assay

Comparison 18 Allergen sensitivity, Outcome two Nasal reactivity after treatment.

19.1
19.1. Analysis

Comparison 19 Quality of life, Outcome 1 Adults.

20.1
20.one. Analysis

Comparison 20 SLIT versus placebo ‐ tablets, Outcome 1 Allergic rhinitis symptom scores.

20.2
20.2. Analysis

Comparison twenty SLIT versus placebo ‐ tablets, Upshot 2 Medication scores.

21.1
21.1. Analysis

Comparing 21 SLIT versus placebo ‐ drops, Outcome 1 Allergic rhinitis symptom scores.

21.2
21.2. Analysis

Comparing 21 SLIT versus placebo ‐ drops, Consequence 2 Medication scores.

Update of

  • Sublingual immunotherapy for allergic rhinitis.

    Wilson DR, Torres LI, Durham SR. Wilson DR, et al. Cochrane Database Syst Rev. 2003;(2):CD002893. doi: 10.1002/14651858.CD002893. Cochrane Database Syst Rev. 2003. PMID: 12804442 Updated. Review.

Like manufactures

  • Systematic reviews of sublingual immunotherapy (SLIT).

    Radulovic S, Wilson D, Calderon Thousand, Durham Southward. Radulovic Southward, et al. Allergy. 2011 Jun;66(half dozen):740-52. doi: 10.1111/j.1398-9995.2011.02583.x. Epub 2011 Mar 28. Allergy. 2011. PMID: 21443635 Review.

  • Sublingual immunotherapy for allergic rhinitis.

    Wilson DR, Torres LI, Durham SR. Wilson DR, et al. Cochrane Database Syst Rev. 2003;(two):CD002893. doi: 10.1002/14651858.CD002893. Cochrane Database Syst Rev. 2003. PMID: 12804442 Updated. Review.

  • Sublingual immunotherapy for allergic rhinitis: systematic review and meta-assay.

    Wilson DR, Lima MT, Durham SR. Wilson DR, et al. Allergy. 2005 Jan;60(one):4-12. doi: 10.1111/j.1398-9995.2005.00699.x. Allergy. 2005. PMID: 15575924 Review.

  • Allergen injection immunotherapy for seasonal allergic rhinitis.

    Calderon MA, Alves B, Jacobson K, Hurwitz B, Sheikh A, Durham S. Calderon MA, et al. Cochrane Database Syst Rev. 2007 Jan 24;2007(1):CD001936. doi: 10.1002/14651858.CD001936.pub2. Cochrane Database Syst Rev. 2007. PMID: 17253469 Gratis PMC article. Review.

  • Sublingual immunotherapy for treating allergic conjunctivitis.

    Calderon MA, Penagos M, Sheikh A, Canonica GW, Durham S. Calderon MA, et al. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD007685. doi: 10.1002/14651858.CD007685.pub2. Cochrane Database Syst Rev. 2011. PMID: 21735416 Review.

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Source: https://pubmed.ncbi.nlm.nih.gov/21154351/

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