Immunotherapy: The Meta-Analyses. What have we Learned?

Calderón, Moisés A.; Boyle, Robert; Penagos, Martín; Sheikh, Aziz

doi:10.1016/j.iac.2011.02.002

Cited by 35 publications

(20 citation statements)

References 38 publications

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“…The new meta-analyses substantially confirmed the previous results, showing an overall efficacy of SLIT for different outcomes. However, the great heterogeneity of the results (due to the inherent heterogeneity of trials) still limits the reliability of the results [60,61]. …”

Section: Chapter 4 Clinical Efficacy Of Sublingual Immunotherapymentioning

confidence: 99%

“…Meta-analysis is a powerful tool for evaluating the efficacy of a therapeutic intervention, and meta-analyses have clearly demonstrated that AIT is effective overall for treating allergic rhinitis and asthma [60]. However, the methodological quality of systematic reviews of SLIT could be improved by including more details about the search strategy used, employing measures to avoid selection bias, assessing the methodological quality of the included studies [213], increasing transparency on sources of funding, and considering heterogeneity before pooling data [214].…”

Section: Introductionmentioning

confidence: 99%

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Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Canonica

Cox

Pawankar

et al. 2014

World Allergy Organization Journal

452

421

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We have prepared this document, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update”, according to the evidence-based criteria, revising and updating chapters of the originally published paper, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2009”, available at http://www.waojournal.org. Namely, these comprise: “Mechanisms of sublingual immunotherapy;” “Clinical efficacy of sublingual immunotherapy” – reporting all the data of all controlled trials published after 2009; “Safety of sublingual immunotherapy” – with the recently published Grading System for adverse reactions; “Impact of sublingual immunotherapy on the natural history of respiratory allergy” – with the relevant evidences published since 2009; “Efficacy of SLIT in children” – with detailed analysis of all the studies; “Definition of SLIT patient selection” – reporting the criteria for eligibility to sublingual immunotherapy; “The future of immunotherapy in the community care setting”; “Methodology of clinical trials according to the current scientific and regulatory standards”; and “Guideline development: from evidence-based medicine to patients' views” – including the evolution of the methods to make clinical recommendations.Additionally, we have added new chapters to cover a few emerging crucial topics: “Practical aspects of schedules and dosages and counseling for adherence” – which is crucial in clinical practice for all treatments; “Perspectives and new approaches” – including recombinant allergens, adjuvants, modified allergens, and the concept of validity of the single products. Furthermore, “Raising public awareness about sublingual immunotherapy”, as a need for our patients, and strategies to increase awareness of allergen immunotherapy (AIT) among patients, the medical community, all healthcare stakeholders, and public opinion, are also reported in detail.

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Section: Chapter 4 Clinical Efficacy Of Sublingual Immunotherapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Canonica

Cox

Pawankar

et al. 2014

World Allergy Organization Journal

452

421

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“…40,42 Another study examined the effectiveness of SLIT with cat extracts on 50 cat-allergic patients with or without asthma. After a year of treatment, asthma symptoms and PEF improved signifi cantly in the active treatment group compared with nonsignifi cant changes with placebo when placed in a "cat room" to simulate natural exposure.…”

Section: The Effect Of Scit For Armentioning

confidence: 99%

“…63 Overall, the data from various studies and metaanalyses of SCIT and SLIT on asthma strike a note of cautious optimism for immunotherapy. There is, however, signifi cant heterogeneity in existing stud- 42 ) or better than, pharmacotherapy in controlling rhinitis symptoms even in the fi rst season of treatment.…”

Section: The Effect Of Scit For Armentioning

confidence: 99%

Allergen Immunotherapy in Allergic Respiratory Diseases

Viswanathan

Busse

2012

Chest

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Over the past 2 decades, the prevalence of allergic respiratory diseases has increased, in part refl ecting changes in lifestyle and environment that promote a T-helper (Th) 2 cell phenotype. 1 It has been estimated that up to 20% of the US and Western Europe populations may be affl icted by allergic respiratory diseases. 2,3 A recent estimate of the total national medical expenditure attributable to adult asthma was reported as $18 billion, with the largest contributors being prescription drugs and inpatient hospitalizations. 4,5 Although allergen avoidance is an integral component and step of therapy, it is often impractical and insuffi cient. As a consequence, the mainstay of allergic disease management has been pharmacotherapy, especially antihistamines, bronchodilators, and inhaled/intranasal corticosteroids, which are targeted to regulate infl ammation of the upper and lower airways. Although these treatments are effective and, in most cases, safe, they offer no lasting benefi t once treatment is stopped and have limited intrinsic disease-modifying effects. Moreover, it has become apparent that allergic diseases are the result of immune dysregulation and refl ect an impairment in the natural tolerance that develops to allergens. 6,7 Immunotherapy has the potential to modify fundamental, underlying disease mechanisms and to have, Allergen-specifi c immunotherapy (SIT) involves the repeated administration of allergenic extracts to atopic individuals over a period of 3 to 5 years either subcutaneously (SCIT) or sublingually (SLIT) for the treatment of allergic respiratory diseases, including asthma and allergic rhinitis (AR). In studies, SCIT and SLIT have been shown to improve existing symptoms of asthma and AR and to also have the capability to cause disease-modifying changes of the underlying atopic condition so as to prevent new allergic sensitization as well as arrest progression of AR to asthma. Recent evidence suggests that immunotherapy brings about these effects through actions that use T-regulatory cells and blocking antibodies such as IgG 4 and IgA 2, which can then result in an "immune deviation" from a T-helper (Th) 2 cell pattern to a Th1 cell pattern. Numerous meta-analyses and studies have been performed to evaluate the existing data among these studies, with the consensus recommendation favoring the use of immunotherapy because of its potential to modify existing diseases. Signifi cant adverse reactions can occur with immunotherapy, including anaphylaxis and, very rarely, death. A primary factor in considering SIT is its potential to provide longlasting effects that are able to be sustained well after its discontinuation. Given the signifi cant burden these allergic diseases impose on the health-care system, SIT appears to be a cost-effective adjunctive treatment in modifying the existing disease state. CHEST 2012; 141(5):1303-1314Abbreviations: AR 5 allergic rhinitis; BHR 5 bronchial hyperresponsiveness; PEF 5 peak expiratory fl ow; SCIT 5 subcutaneous immunotherapy; SIT 5 allergen-specifi c...

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“…1 Meta-analyses are powerful tool to elucidate the efficacy of immunotherapy against allergy and also provide for a glimpse on the role covered by recombinant allergens used to desensitize cellular response to allergy. [2][3][4][5] Numerous comparative studies with specific immunotherapy vs placebo or pharmacological treatment have demonstrated the efficacy of this approach and its advantage in control of the disease. Allergen specific immunotherapy (AIT) induces favorable clinical, biological, and functional modifications in the course of allergic asthma.…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy in allergy and cellular tests

Chirumbolo

2014

Human Vaccines & Immunotherapeutics

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Immunotherapy: The Meta-Analyses. What have we Learned?

Cited by 35 publications

References 38 publications

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Allergen Immunotherapy in Allergic Respiratory Diseases

Immunotherapy in allergy and cellular tests

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