Open AccessAllergen-specific immunotherapy for local allergic rhinitis: a systematic review and meta-analysis
Author(s) -
Minh P. Hoang,
J Samuthpongtorn,
Wirach Chitsuthipakorn,
Kachorn Seresirikachorn,
Kornkiat Snidvongs
Publication year - 2021
Publication title -
rhinology (amsterdam. online)/rhinology
Language(s) - English
Resource type - Journals
eISSN - 1996-8604
pISSN - 0300-0729
DOI - 10.4193/rhin21.193
Subject(s) - medicine , discontinuation , observational study , adverse effect , placebo , quality of life (healthcare) , randomized controlled trial , immunotherapy , meta analysis , allergen , allergy , allergen immunotherapy , immunology , alternative medicine , pathology , cancer , nursing
Background: Local allergic rhinitis (LAR) is a phenotype of chronic rhinitis exhibiting a local Th2-driven inflammation without positive clinical markers of atopy. Immunomodulatory effects of allergen-specific immunotherapy (AIT) induce allergen-specific tolerance. However, AIT is not well-recognized as a treatment for LAR. Methodology: Systematic search on six electronic databases and registries was performed. Experimental and observational studies of AIT for LAR patients were retrieved. The primary outcomes were symptom score, medication score, combined symptom medication score, and disease-specific quality of life. Secondary outcomes were serum specific(s) IgG4, sIgE, and adverse events. Results: Four double-blind randomized controlled trials (156 patients) from two research units assessed the effects of subcutaneous immunotherapy (SCIT). Compared with placebo, SCIT showed significant reductions in symptom score, medication score, combined symptom medication score, disease-specific quality of life, and an increase in serum sIgG4. There was no significant change in serum sIgE. Likewise, two observational studies (one using SCIT and one using sublingual immunotherapy) improved post-therapeutic symptom score. No studies assessed the effects after discontinuation of treatment. AIT was safe without serious adverse events. Conclusion: AIT has beneficial effects and safe for LAR. Its effects are restricted to studies with short-term follow-up. AIT may be considered in LAR patients.