Efficacy of allergen-specific immunotherapy for atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials

Jung Min Bae, Yoon Young Choi, Chang Ook Park, Kee Yang Chung, Kwanghoon Lee

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Background: Allergen-specific immunotherapy (allergen-SIT) is the only treatment directed at the cause of IgE-mediated allergic diseases. However, there is controversy over the use of SIT for patients with atopic dermatitis. Objective: We performed a systematic review and meta-analysis to assess the efficacy of SIT for patients with atopic dermatitis. Methods: We performed manual searches of reference lists and computerized searches of the MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane databases (through December 10, 2012) for randomized controlled trials that compared SIT with placebo for patients with atopic dermatitis. The outcome of interest was a dichotomous variable, in terms of treatment success; a meta-analysis was performed by using a randomeffects analysis. Subgroup analyses were carried out to evaluate the effects of long-term treatment (more than 1 year), SIT for severe atopic dermatitis, SIT for children, and subcutaneous and sublingual administration of immunotherapy. Results: We analyzed 8 randomized controlled trials that comprised a total of 385 subjects. We found that SIT has a significant positive effect on atopic dermatitis (odds ratio [OR], 5.35; 95% CI, 1.61-17.77; number needed to treat, 3; 95% CI, 2-9). SIT also showed significant efficacy in long-term treatment (OR, 6.42; 95% CI, 1.50-27.52) for patients with severe atopic dermatitis (OR, 3.13; 95% CI, 1.31-7.48), and when administered subcutaneously (OR, 4.27; 95% CI, 1.36-13.39). Conclusions: A meta-analysis provides moderate-level evidence for the efficacy of SIT against atopic dermatitis. However, these findings are based on an analysis of a small number of randomized controlled trials, with considerable heterogeneity among trials.

Original languageEnglish
Pages (from-to)110-117
Number of pages8
JournalJournal of Allergy and Clinical Immunology
Volume132
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Immunologic Desensitization
Atopic Dermatitis
Meta-Analysis
Randomized Controlled Trials
Odds Ratio
Sublingual Administration
Sublingual Immunotherapy
Numbers Needed To Treat
Therapeutics
MEDLINE
Immunoglobulin E
Placebos
Databases

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

Cite this

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title = "Efficacy of allergen-specific immunotherapy for atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials",
abstract = "Background: Allergen-specific immunotherapy (allergen-SIT) is the only treatment directed at the cause of IgE-mediated allergic diseases. However, there is controversy over the use of SIT for patients with atopic dermatitis. Objective: We performed a systematic review and meta-analysis to assess the efficacy of SIT for patients with atopic dermatitis. Methods: We performed manual searches of reference lists and computerized searches of the MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane databases (through December 10, 2012) for randomized controlled trials that compared SIT with placebo for patients with atopic dermatitis. The outcome of interest was a dichotomous variable, in terms of treatment success; a meta-analysis was performed by using a randomeffects analysis. Subgroup analyses were carried out to evaluate the effects of long-term treatment (more than 1 year), SIT for severe atopic dermatitis, SIT for children, and subcutaneous and sublingual administration of immunotherapy. Results: We analyzed 8 randomized controlled trials that comprised a total of 385 subjects. We found that SIT has a significant positive effect on atopic dermatitis (odds ratio [OR], 5.35; 95{\%} CI, 1.61-17.77; number needed to treat, 3; 95{\%} CI, 2-9). SIT also showed significant efficacy in long-term treatment (OR, 6.42; 95{\%} CI, 1.50-27.52) for patients with severe atopic dermatitis (OR, 3.13; 95{\%} CI, 1.31-7.48), and when administered subcutaneously (OR, 4.27; 95{\%} CI, 1.36-13.39). Conclusions: A meta-analysis provides moderate-level evidence for the efficacy of SIT against atopic dermatitis. However, these findings are based on an analysis of a small number of randomized controlled trials, with considerable heterogeneity among trials.",
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Efficacy of allergen-specific immunotherapy for atopic dermatitis : A systematic review and meta-analysis of randomized controlled trials. / Bae, Jung Min; Choi, Yoon Young; Park, Chang Ook; Chung, Kee Yang; Lee, Kwanghoon.

In: Journal of Allergy and Clinical Immunology, Vol. 132, No. 1, 01.01.2013, p. 110-117.

Research output: Contribution to journalArticle

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