Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic overview of systematic reviews
Year: 2017
Type: review
Study design: Systematic Review
Abstract: 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.
Authors: 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
Institutions: Cardiff University, University of Messina, Charité – Universitätsmedizin Berlin, University Hospital Southampton NHS Foundation Trust, NIHR Southampton Biomedical Research Centre, St Mary's Hospital, David Hide Asthma and Allergy Research Centre, University of Southampton, Heidelberg University, Zentrum für Rhinologie und Allergologie, University Medical Centre Mannheim, Medizinische Fakultät Mannheim, Azienda Ospedale - Università Padova, Imperial College London, Eskişehir Osmangazi University, Erasmus MC, Odense University Hospital, Universitair Ziekenhuis Leuven, University Medical Center Utrecht, Hospital Médica Sur, Johns Hopkins University, Johns Hopkins Medicine, Johns Hopkins Hospital, National and Kapodistrian University of Athens, Panagiotis & Aglaia Kyriakou Children's Hospital, University Medical Center Groningen, University of Groningen, Nippon Medical School, University of Milan, University of Cyprus, Royal National Throat Nose and Ear Hospital, University College London, University of Graz, Medical University of Graz, European Union, Guy's and St Thomas' NHS Foundation Trust, University of Edinburgh
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,690
Funders: Sanofi, Johns Hopkins University, University of Cyprus, Allergy Therapeutics, University College London, European Commission, University of Edinburgh, Rijksuniversiteit Groningen, Universitair Medisch Centrum Groningen, National and Kapodistrian University of Athens, European Academy of Allergy and Clinical Immunology, Novartis Pharma, Allergopharma
OpenAlex ID: W2732964511