TY - JOUR
T1 - Sublingual immunotherapy vs placebo in the management of grass pollen-induced allergic rhinitis in adults
T2 - A systematic review and meta-analysis
AU - Boldovjáková, Dominika
AU - Cordoni, Sara
AU - Fraser, Craig John
AU - Love, Aimee Beth
AU - Patrick, Lorna
AU - Ramsay, Gary James
AU - Ferguson, Aaron Stephen James
AU - Gomati, Anas
AU - Ram, Bhaskar
N1 - Funding Information:
With thanks to Dr Neil Scott, MA, MSc, PhD (Medical Statistics Team, Division of Applied Health Sciences, University of Aberdeen) for statistical consultation and support.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2021/1
Y1 - 2021/1
N2 - Introduction: Allergic rhinitis (AR) is a common inflammatory condition of the nasal mucosa affecting approximately 20% of the population worldwide. Current therapies include intranasal antihistamines, corticosteroids, subcutaneous and sublingual immunotherapy (SLIT). This review and meta-analysis assess the efficacy of SLIT in the management of grass pollen-induced AR in adults.Methods: Ovid EMBASE, Ovid EBM Reviews, Cochrane Central Register of Controlled Trials, Ovid MedLine and PubMed were searched using the following terms: ‘sublingual immunotherapy’, ‘SLIT’, ‘rhinitis’, ‘allergic rhinitis’, ‘rhinosinusitis’ and ‘rhino-conjunctivitis’. All included studies were double-blind, placebo-controlled and randomised trials. Primary outcome was symptom score and secondary outcome included quality of life and safety profile. Meta-analysis of symptom improvement was carried out.Results: Six studies were identified with 979 subjects randomly allocated to SLIT and 992 to a placebo control. All studies reported an improvement in symptoms with SLIT, with five reaching statistical significance (P <.05). Four studies reported statistically significant improvement in quality of life (P <.05). Oral pruritus was the most common adverse event reported. The overall risk of bias was high in 50% of the studies.Conclusions: Sublingual immunotherapy was a safe and effective treatment for grass pollen-induced AR in adults, and therefore, consideration should be given to its use for moderate-to-severe disease in the UK-wide population.
AB - Introduction: Allergic rhinitis (AR) is a common inflammatory condition of the nasal mucosa affecting approximately 20% of the population worldwide. Current therapies include intranasal antihistamines, corticosteroids, subcutaneous and sublingual immunotherapy (SLIT). This review and meta-analysis assess the efficacy of SLIT in the management of grass pollen-induced AR in adults.Methods: Ovid EMBASE, Ovid EBM Reviews, Cochrane Central Register of Controlled Trials, Ovid MedLine and PubMed were searched using the following terms: ‘sublingual immunotherapy’, ‘SLIT’, ‘rhinitis’, ‘allergic rhinitis’, ‘rhinosinusitis’ and ‘rhino-conjunctivitis’. All included studies were double-blind, placebo-controlled and randomised trials. Primary outcome was symptom score and secondary outcome included quality of life and safety profile. Meta-analysis of symptom improvement was carried out.Results: Six studies were identified with 979 subjects randomly allocated to SLIT and 992 to a placebo control. All studies reported an improvement in symptoms with SLIT, with five reaching statistical significance (P <.05). Four studies reported statistically significant improvement in quality of life (P <.05). Oral pruritus was the most common adverse event reported. The overall risk of bias was high in 50% of the studies.Conclusions: Sublingual immunotherapy was a safe and effective treatment for grass pollen-induced AR in adults, and therefore, consideration should be given to its use for moderate-to-severe disease in the UK-wide population.
KW - allergic
KW - poaceae
KW - pollen
KW - rhinitis
KW - sublingual immunotherapy
UR - http://www.scopus.com/inward/record.url?scp=85092379193&partnerID=8YFLogxK
U2 - 10.1111/coa.13651
DO - 10.1111/coa.13651
M3 - Review article
C2 - 32979035
AN - SCOPUS:85092379193
SN - 1749-4478
VL - 46
SP - 52
EP - 59
JO - Clinical Otolaryngology
JF - Clinical Otolaryngology
IS - 1
ER -