Clinical Evaluation of Allergen Immunotherapy for Allergic Rhinitis

Area of Science:

• Immunology
• Allergy and Clinical Immunology
• Pharmacology

Background:

• Allergen immunotherapy (AIT) is the only disease-modifying treatment for allergic diseases, offering lasting symptom and medication reduction.
• While AIT (subcutaneous and sublingual) is recognized as safe and effective for allergic rhinitis in all age groups, comprehensive evaluations integrating randomized controlled trials (RCTs) and real-world evidence (RWE) are limited.

Purpose of the Study:

• To comprehensively evaluate the safety and efficacy of AIT for allergic rhinitis in adult and pediatric populations.
• To integrate findings from both RCTs and RWE to provide a holistic view of AIT's clinical outcomes.

Main Methods:

• A narrative literature search was conducted in PubMed up to January 2026.
• Keywords included "allergen immunotherapy," "AIT," "safety," "efficacy," "clinical outcome," and "clinical evaluation."
• Data from RCTs and RWE studies analyzing AIT safety and efficacy in children and adults were evaluated.

Main Results:

• Both SCIT and SLIT significantly reduced allergic rhinitis symptoms, medication requirements, and improved quality of life (QoL) across studies.
• Large SLIT tablet trials demonstrated efficacy in adults and children, with RWE supporting broader population effectiveness.
• SCIT showed a slightly higher risk of systemic reactions compared to SLIT, which primarily caused mild local effects.

Conclusions:

• AIT, encompassing both SCIT and SLIT, is a safe and effective treatment for allergic rhinitis, supported by both RCTs and RWE.
• Integrating RWE with RCT findings is crucial for developing clinical guidelines, especially for understanding long-term effects and real-world applicability.