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META ANALYSIS
Year : 2018  |  Volume : 131  |  Issue : 21  |  Page : 2583-2588

Sublingual Immunotherapy Tablets Relieve Symptoms in Adults with Allergic Rhinitis: A Meta-analysis of Randomized Clinical Trials


1 Emergency Department, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
2 Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730, China
3 Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing 100034, China

Correspondence Address:
Dr. Jin-Lyu Sun
Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.244108

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Background: Sublingual immunotherapy (SLIT) has been proven to be effective against house dust mite-induced allergic rhinitis. However, the efficacy in adults with allergic rhinitis has never been reported on SLIT tablets. The current meta-analysis aimed to illustrate the differentiated efficacy of SLIT tablets on allergic rhinitis. Methods: Our systematic review and meta-analysis were performed on allergic rhinitis patients and aimed to summarize those randomized controlled studies (RCTs). PubMed, EMBASE, Cochrane library, and MEDLINE were screened for associated articles. We included RCTs on allergic rhinitis patients undergoing SLIT therapy and reporting outcomes on symptom relief and serum-specific IgE levels. The effect of SLIT tablets on the Rhinitis Quality Life Questionnaire Score (RQLQ), Rhinitis Total Symptom Score (RTSS), and serum-specific IgE levels was evaluated using RevMan 5.3. Results: Seven studies were included, with 2723 patients identified. All of the studies were RCT. The included seven studies were all conducted on adults. Among the included seven articles, five researches administered patients with SLIT tablets and were eligible for meta-analysis of RTSS, consisting of 1490 patients. Overall, RTSS was significantly reduced in the SLIT tablet group compared with that in the placebo group (standard mean difference = −0.33, 95% confidence interval [−0.54, −0.13], P < 0.01). There was no significant difference in specific IgE levels between SLIT and placebo patients. Conclusions: SLIT tablets effectively relieve rhinitis symptoms in adults with allergic rhinitis. Nevertheless, the current evidence may be limited due to sample size and the heterogeneity between studies. Large sample size and multiple center RCTs on the efficacy of different formulations of SLIT drugs are still needed to provide further evidence and a more precise recommendation.

 

 Abstract in Chinese

尘螨过敏性鼻炎成年患者使用舌下含服片剂可缓解临床症状:随机临床试验荟萃分析

摘要

背景:舌下免疫疗法(SLIT)已被证明可有效对抗屋尘螨诱发的过敏性鼻炎。 然而,目前尚无SLIT片剂对成人过敏性鼻炎的报道。我们的系统评价旨在分析讨论SLIT片剂对成人过敏性鼻炎的疗效。

方法:通过检索PubMed,EMBASE,Cochrane图书馆和MEDLINE筛选相关文章,本研究应用RevMan 5.3对数据进行整合分析,报告过敏性鼻炎患者经SLIT片剂治疗后症状缓解情况和血清特异性IgE水平。

结果:该荟萃分析纳入7项研究,总计包含2723成年名患者。所有研究均为随机对照研究(RCT)。7篇文章中,5名给予SLIT片剂的患者并且报道了鼻炎总症状评分。总体而言,与安慰剂组相比,SLIT片剂组中的RTSS显着降低[标准平均差异(SMD)=-0.33,95%置信区间(95%CI)(-0.54,-0.13),P = 0.00]。SLIT和安慰剂患者之间IgE水平没有显着差异。

结论:SLIT片剂可有效缓解成人过敏性鼻炎的鼻炎症状。然而,由于样本量和研究之间的异质性较大,目前的证据尚不足以形成指南。目前仍需大样本量、多中心RCT对不同种类SLIT药物的作用提供进一步的证据。



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