Efficacy and Safety of Sublingual Immunotherapy for Allergic Rhinitis in Pediatric Patients: A Meta-Analysis of Randomized Controlled Trials

Feng, Bohai; Wu, Jueting; Chen, Bobei; Xiang, Haijie; Chen, Ruru; Li, Bangliang; Chen, Si

doi:10.2500/ajra.2017.31.4382

Cited by 24 publications

(19 citation statements)

References 60 publications

(150 reference statements)

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“…SLIT effectively treated pollen‐induced pediatric AC ( p < 0.0001) but not mite‐induced AC ( p = 0.34). Interestingly, earlier studies have reported similar results in pediatric AR patients. It was concluded that SLIT effectively treated pediatric AR caused by grass pollen but was less effective against house dust mite–induced pediatric AR.…”

Section: Discussionsupporting

confidence: 71%

Sublingual immunotherapy for pediatric allergic conjunctivitis: a meta‐analysis of randomized controlled trials

Yang

Zhang

Zhao

et al. 2018

Int Forum Allergy Rhinol

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Section: Discussionsupporting

confidence: 71%

Sublingual immunotherapy for pediatric allergic conjunctivitis: a meta‐analysis of randomized controlled trials

Yang

Zhang

Zhao

et al. 2018

Int Forum Allergy Rhinol

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“…Compared to placebo, adjusted gains in the SLIT group remained significant. The previous meta‐analyses found that SLIT (drops) was effective in the treatment of AR, but no significant benefits were found for HDM SLIT in children with PAR 22‐25 . They pointed out that the possible reasons for this phenomenon were poor compliance, low doses, twice‐weekly treatment regimens, and small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

“…Previous meta‐analyses found that SCIT can effectively treat AR, but for children with PAR, HDM SLIT is still controversial 22‐25 . Most randomized controlled trials (RCTs) were conducted in adults with grass antigens.…”

mentioning

confidence: 99%

Specific sublingual immunotherapy in children with perennial rhinitis: a systemic review and meta‐analysis

Chen

Lei

Cai

et al. 2020

Int Forum Allergy Rhinol

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Background Allergic rhinitis (AR) is a major public health problem and is increasing worldwide. AR affects children's learning efficiency, sleep quality, and other major aspects of life. Sublingual immunotherapy (SLIT) is effective and safe for children with seasonal AR, but for children with perennial allergic rhinitis (PAR) caused by house dust mites (HDM), its effectiveness and safety is less convincing. Methods Medical literature databases up to 2019 were searched for published and unpublished pieces of evidence. Studies were individually screened by 2 reviewers against the eligibility criteria. Primary outcomes were total nasal symptoms scores (TNSS) and total medication scores (TMS). The secondary outcomes were total ocular symptoms scores and adverse events (AEs). Random effect models and fixed‐effect models were used to calculate the standard mean difference (SMD) and risk ratio (RR), respectively. Results We identified 3772 abstracts, of which only 16 studies met our established criteria. SLIT significantly reduced TNSS (SMD –1.73; 95% CI, –2.62 to –0.84; p = 0.0001) and TMS (SMD –1.21; 95% CI, –1.75 to –0.67; p < 0.00001). Compared with children taking placebo, children taking SLIT were 1.08 (95% CI, 1 to 1.17; p = 0.05), 1.15 (95% CI, 0.87 to 1.51; p = 0.32), and 1.68 (95% CI, 0.68 to 4.11; p = 0.26) times more likely to develop mild, moderate, and severe AEs, respectively. Conclusion HDM SLIT can effectively alleviate TNSS and TMS in children with PAR, but care should be taken to avoid harm due to possible adverse drug reactions.

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“… 10 Moreover, most clinical trials and meta-analysis confirm a significantly more reliable efficacy and better safety profile of SLIT compared with placebo for management of pollen-induced AR or allergic rhinoconjunctivitis. 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

Artemisia Annua sublingual immunotherapy for seasonal allergic rhinitis: A multicenter, randomized trial

Lou

Wang

Wei³

et al. 2020

World Allergy Organization Journal

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Background Artemisia annua is the most common outdoor aeroallergen throughout Northern China; however, no multicenter study has investigated sublingual immunotherapy (SLIT) as a treatment option for Artemisia annua -induced allergic rhinitis (AR). The aim of this study was to evaluate the efficacy and safety of an innovative SLIT for Artemisia annua -related AR. Methods This was a randomized, double-blind, placebo-controlled, multicenter, phase 3 clinical trial conducted in China (NCT XXX). A total of 702 Artemisia annua -sensitized eligible patients were randomized in a ratio of 2:1 to receive Artemisia annua -SLIT or placebo. The treatment lasted 32 weeks; including 5-weeks up-dosing phase and 27-weeks maintenance phase. The primary endpoint was the daily combined score of medication and rhinoconjunctivitis symptom (CSMRS), and secondary endpoints were daily total nasal symptom score (dTNSS) and daily rescue medication score (dRMS) during peak pollen period. Safety of treatment was evaluated according to adverse events (AEs) experienced. Results Mean daily CSMRS was significantly improved during the peak pollen period in the SLIT group compared with the placebo group (1.46 ± 0.47 vs 1.88 ± 0.42, P < 0.0001 in full analysis set [FAS]; 1.49 ± 0.52 vs 1.95 ± 0.46, P < 0.0001 in per protocol set [PPS]); representing a 22.3% and 23.6% reduction, respectively, relative to placebo. In specifically Artemisia annua monosensitized patients, mean daily CSMRS reductions were demonstrated as 24.1% and 27.0% in the FAS and PPS populations, respectively, when comparing the active treatment to placebo treatment. Similarly, SLIT decreased dTNSS in peak pollen period by 19.0% in FAS and 22.3% in PPS, respectively, relative to placebo. In coincidence, dRMS in peak pollen period was reduced by 22.0% in FAS and 26.0% in PPS. 65.8% patients in SLIT group experienced treatment-related AEs, none of which was serious. Conclusion This study indicates that SLIT with Artemisia annua drops is an effective and safe treatment option in Chinese patients with Artemisia Annua -induced AR.

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Efficacy and Safety of Sublingual Immunotherapy for Allergic Rhinitis in Pediatric Patients: A Meta-Analysis of Randomized Controlled Trials

Abstract: Our meta-analysis results indicated that SLIT provided significant symptom relief and reduced the need for medication in pediatric patients. Moreover, the safety of SLIT needs to be confirmed in RCTs with larger samples.

Cited by 24 publications

References 60 publications

Sublingual immunotherapy for pediatric allergic conjunctivitis: a meta‐analysis of randomized controlled trials

Sublingual immunotherapy for pediatric allergic conjunctivitis: a meta‐analysis of randomized controlled trials

Specific sublingual immunotherapy in children with perennial rhinitis: a systemic review and meta‐analysis

Artemisia Annua sublingual immunotherapy for seasonal allergic rhinitis: A multicenter, randomized trial

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