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Sublingual immunotherapy vs placebo in the management of grass pollen‐induced allergic rhinitis in adults: A systematic review and meta‐analysis
Author(s) -
Boldovjáková Dominika,
Cordoni Sara,
Fraser Craig John,
Love Aimee Beth,
Patrick Lorna,
Ramsay Gary James,
Ferguson Aaron Stephen James,
Gomati Anas,
Ram Bhaskar
Publication year - 2021
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13651
Subject(s) - medicine , slit , placebo , meta analysis , sublingual immunotherapy , adverse effect , population , randomized controlled trial , sublingual administration , systematic review , dermatology , medline , immunotherapy , immunology , alternative medicine , pathology , genetics , environmental health , cancer , political science , law , biology
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.