Allergen immunotherapy for the prevention of allergy: a systematic review and meta-analysis
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Allergen immunotherapy for the prevention of allergy : a systematic review and meta-analysis. / Kristiansen, Maria; Dhami, Sangeeta; Netuveli, Gopal; Halken, Susanne; Antonella, Muraro; Roberts, Graham; Larenas-Linnemann, Desiree; Calderón, Moises A.; Penagos, Martin; Du Toit, George; Ansotegui, Ignacio J.; Kleine-Tebbe, Jörg; Lau, Susanne; Matricardi, Paolo Maria; Pajno, Giovanni; Papadopoulos, Nikolaos G.; Pfaar, Oliver; Ryan, Dermot; Santos, Alexandra F. ; Timmermanns, Frans; Wahn, Ulrich; Sheikh, Aziz.
I: Pediatric Allergy and Immunology, Bind 28, Nr. 1, 02.2017, s. 18–29.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Allergen immunotherapy for the prevention of allergy
T2 - a systematic review and meta-analysis
AU - Kristiansen, Maria
AU - Dhami, Sangeeta
AU - Netuveli, Gopal
AU - Halken, Susanne
AU - Antonella, Muraro
AU - Roberts, Graham
AU - Larenas-Linnemann, Desiree
AU - Calderón, Moises A.
AU - Penagos, Martin
AU - Du Toit, George
AU - Ansotegui, Ignacio J.
AU - Kleine-Tebbe, Jörg
AU - Lau, Susanne
AU - Matricardi, Paolo Maria
AU - Pajno, Giovanni
AU - Papadopoulos, Nikolaos G.
AU - Pfaar, Oliver
AU - Ryan, Dermot
AU - Santos, Alexandra F.
AU - Timmermanns, Frans
AU - Wahn, Ulrich
AU - Sheikh, Aziz
PY - 2017/2
Y1 - 2017/2
N2 - Background: There is a need to establish the effectiveness, cost-effectiveness and safety of allergen immunotherapy (AIT) for the prevention of allergic disease.Methods:Two reviewers independently screened nine international biomedical databases. Studies were quantitatively synthesized using random-effects meta-analyses.Results: 32 studies satisfied the inclusion criteria. Overall, meta-analysis found no conclusive evidence that AIT reduced the risk of developing a first allergic disease over the short-term (RR=0.30; 95%CI 0.04 to 2.09) and no randomized controlled evidence was found in relation to its longer-term effects for this outcome. There was however a reduction in the short-term risk of those with allergic rhinitis developing asthma (RR=0.40; 95%CI 0.29 to 0.54), with this finding being robust to a pre-specified sensitivity analysis. We found inconclusive evidence that this benefit was maintained over the longer-term: RR=0.62; 95%CI 0.31 to 1.23. There was evidence that the risk of new sensitization was reduced over the short-term, but this was not confirmed in the sensitivity analysis: RR=0.72; 95%CI 0.24 to 2.18. There was no clear evidence of any longer-term reduction in the risk of sensitization: RR=0.47; 95%CI 0.08 to 2.77. AIT appeared to have an acceptable side-effect profile.Conclusions: AIT did not result in a statistically significant reduction in the risk of developing a first allergic disease. There was however evidence of a reduced short-term risk of developing asthma in those with allergic rhinitis, but it is unclear whether this benefit was maintained over the longer-term. We are unable to comment on the cost-effectiveness of AIT.
AB - Background: There is a need to establish the effectiveness, cost-effectiveness and safety of allergen immunotherapy (AIT) for the prevention of allergic disease.Methods:Two reviewers independently screened nine international biomedical databases. Studies were quantitatively synthesized using random-effects meta-analyses.Results: 32 studies satisfied the inclusion criteria. Overall, meta-analysis found no conclusive evidence that AIT reduced the risk of developing a first allergic disease over the short-term (RR=0.30; 95%CI 0.04 to 2.09) and no randomized controlled evidence was found in relation to its longer-term effects for this outcome. There was however a reduction in the short-term risk of those with allergic rhinitis developing asthma (RR=0.40; 95%CI 0.29 to 0.54), with this finding being robust to a pre-specified sensitivity analysis. We found inconclusive evidence that this benefit was maintained over the longer-term: RR=0.62; 95%CI 0.31 to 1.23. There was evidence that the risk of new sensitization was reduced over the short-term, but this was not confirmed in the sensitivity analysis: RR=0.72; 95%CI 0.24 to 2.18. There was no clear evidence of any longer-term reduction in the risk of sensitization: RR=0.47; 95%CI 0.08 to 2.77. AIT appeared to have an acceptable side-effect profile.Conclusions: AIT did not result in a statistically significant reduction in the risk of developing a first allergic disease. There was however evidence of a reduced short-term risk of developing asthma in those with allergic rhinitis, but it is unclear whether this benefit was maintained over the longer-term. We are unable to comment on the cost-effectiveness of AIT.
KW - Faculty of Health and Medical Sciences
KW - Immunotherapy
KW - Allergy and Immunology
KW - Systematic review
KW - Meta-analysis
U2 - 10.1111/pai.12661
DO - 10.1111/pai.12661
M3 - Journal article
C2 - 27653623
VL - 28
SP - 18
EP - 29
JO - Pediatric Allergy and Immunology, Supplement
JF - Pediatric Allergy and Immunology, Supplement
SN - 0906-5784
IS - 1
ER -
ID: 166059175