Publication

Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic overview of systematic reviews

Nurmatov, U., Dhami, S., Arasi, S., Roberts, G., Pfaar, O., Muraro, A., Ansotegui, I. J., Calderon, M., Cingi, C., Durham, S., van Wijk, R. G., Halken, S., Hamelmann, E., Hellings, P., Jacobsen, L., Knol, E., Larenas-Linnemann, D., Lin, S. Y., Maggina, V., Oude-Elberink, H., Pajno, G., Panwankar, R., Pastorello, E., Pitsios, C., Rotiroti, G., Timmermans, F., Tsilochristou, O., Varga, E-M., Wilkinson, J., Williams, A., Worm, M., Zhang, L. & Sheikh, A. 8-Aug-2017 In : Clinical and translational allergy. 7, 16 p., 24

Research output: Scientific - peer-reviewReview article

  • Ulugbek Nurmatov
  • Sangeeta Dhami
  • Stefania Arasi
  • Graham Roberts
  • Oliver Pfaar
  • Antonella Muraro
  • Ignacio J. Ansotegui
  • Moises Calderon
  • Cemal Cingi
  • Stephen Durham
  • Roy Gerth van Wijk
  • Susanne Halken
  • Eckard Hamelmann
  • Peter Hellings
  • Lars Jacobsen
  • Edward Knol
  • Desiree Larenas-Linnemann
  • Sandra Y. Lin
  • Vivian Maggina
  • Hanneke Oude-Elberink
  • Giovanni Pajno
  • Ruby Panwankar
  • Elideanna Pastorello
  • Constantinos Pitsios
  • Giuseppina Rotiroti
  • Frans Timmermans
  • Olympia Tsilochristou
  • Eva-Maria Varga
  • Jamie Wilkinson
  • Andrew Williams
  • Margitta Worm
  • Luo Zhang
  • Aziz Sheikh

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis (ARC). To inform the development of recommendations, we sought to critically assess the systematic review evidence on the effectiveness, safety and cost-effectiveness of AIT for ARC.

Methods: We undertook a systematic overview, which involved searching nine international biomedical databases from inception to October 31, 2015. Studies were independently screened by two reviewers against pre-defined eligibility criteria and critically appraised using the Critical Appraisal Skills Programme (CASP) Systematic Review Checklist for systematic reviews. Data were descriptively synthesized.

Results: Our searches yielded a total of 5932 potentially eligible studies, from which 17 systematic reviews met our inclusion criteria. Eight of these were judged to be of high, five moderate and three low quality. These reviews suggested that, in carefully selected patients, subcutaneous (SCIT) and sublingual (SLIT) immunotherapy resulted in significant reductions in symptom scores and medication requirements. Serious adverse outcomes were rare for both SCIT and SLIT. Two systematic reviews reported some evidence of potential cost savings associated with use of SCIT and SLIT.

Conclusions: We found moderate-to-strong evidence that SCIT and SLIT can, in appropriately selected patients, reduce symptoms and medication requirements in patients with ARC with reassuring safety data. This evidence does however need to be interpreted with caution, particularly given the heterogeneity in the populations, allergens and protocols studied. There is a lack of data on the relative effectiveness, cost-effectiveness and safety of SCIT and SLIT. We are now systematically reviewing all the primary studies, including recent evidence that has not been incorporated into the published systematic reviews.

Original languageEnglish
Article number24
Number of pages16
JournalClinical and translational allergy
Volume7
StatePublished - 8-Aug-2017

    Keywords

  • Allergy, Allergen immunotherapy, Allergic rhinitis, Allergic rhinoconjuctivitis, Hay fever, Rhinitis, SUBLINGUAL IMMUNOTHERAPY, SUBCUTANEOUS IMMUNOTHERAPY, RHINITIS, ASTHMA, IMPACT, RECOMMENDATIONS, METAANALYSIS, CHILDREN, EFFICACY, QUALITY

View graph of relations

ID: 46989408