TY - JOUR
T1 - Allergen immunotherapy for allergic rhinoconjunctivitis
T2 - A systematic overview of systematic reviews
AU - Nurmatov, Ulugbek
AU - Dhami, Sangeeta
AU - Arasi, Stefania
AU - Roberts, Graham
AU - Pfaar, Oliver
AU - Muraro, Antonella
AU - Ansotegui, Ignacio J.
AU - Calderon, Moises
AU - Cingi, Cemal
AU - Durham, Stephen
AU - Van Wijk, Roy Gerth
AU - Halken, Susanne
AU - Hamelmann, Eckard
AU - Hellings, Peter
AU - Jacobsen, Lars
AU - Knol, Edward
AU - Larenas-Linnemann, Desiree
AU - Lin, Sandra Y.
AU - Maggina, Vivian
AU - Oude-Elberink, Hanneke
AU - Pajno, Giovanni
AU - Panwankar, Ruby
AU - Pastorello, Elideanna
AU - Pitsios, Constantinos
AU - Rotiroti, Giuseppina
AU - Timmermans, Frans
AU - Tsilochristou, Olympia
AU - Varga, Eva Maria
AU - Wilkinson, Jamie
AU - Williams, Andrew
AU - Worm, Margitta
AU - Zhang, Luo
AU - Sheikh, Aziz
N1 - Publisher Copyright:
© 2017 The Author(s).
PY - 2017/8/8
Y1 - 2017/8/8
N2 - 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.
AB - 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.
KW - Allergen immunotherapy
KW - Allergic rhinitis
KW - Allergic rhinoconjuctivitis
KW - Allergy
KW - Hay fever
KW - Rhinitis
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U2 - 10.1186/s13601-017-0159-6
DO - 10.1186/s13601-017-0159-6
M3 - Review article
C2 - 28794855
AN - SCOPUS:85026902940
SN - 2045-7022
VL - 7
JO - Clinical and Translational Allergy
JF - Clinical and Translational Allergy
IS - 1
M1 - 24
ER -