Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis

Area of Science:

• Allergy and Clinical Immunology
• Otolaryngology
• Pharmacology

Background:

• The European Academy of Allergy and Clinical Immunology (EAACI) is developing guidelines for Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis.
• A systematic review was conducted to evaluate the effectiveness, cost-effectiveness, and safety of AIT.
• This review informs clinical recommendations for managing allergic rhinoconjunctivitis.

Purpose of the Study:

• To systematically review the evidence on the effectiveness of AIT for allergic rhinoconjunctivitis.
• To assess the cost-effectiveness and safety of AIT in managing this condition.
• To provide evidence-based recommendations for AIT in clinical practice.

Main Methods:

• Searched nine international biomedical databases for diverse evidence types.
• Two independent reviewers screened and appraised studies against eligibility criteria.
• Utilized random-effects meta-analyses for quantitative synthesis of primary outcomes (symptoms, medication use) and secondary outcomes (cost-effectiveness, safety).

Main Results:

• 160 studies met eligibility criteria from an initial search of 5960.
• AIT demonstrated significant reductions in symptom, medication, and combined scores during treatment (SMD -0.53, -0.37, -0.49 respectively).
• Evidence suggests sustained symptom score benefits post-AIT discontinuation, though less robust than during treatment.

Conclusions:

• Allergen immunotherapy (AIT) is effective for improving symptom and medication scores in allergic rhinoconjunctivitis patients during treatment.
• Evidence indicates that AIT benefits, particularly for symptom scores, may continue after therapy cessation.
• The findings support the use of AIT as a management strategy for allergic rhinoconjunctivitis.