Specific sublingual immunotherapy in children with perennial rhinitis: a systemic review and meta-analysis

被引:9
作者
Chen, Liang [1 ]
Lei, Lijuan [1 ]
Cai, Yinghuang [1 ]
Li, Tianlin [1 ]
机构
[1] Xiamen Chang Gung Mem Hosp, Dept Pulm Allergy & Clin Care Med, 123 Xiafei, Xiamen, Peoples R China
关键词
allergic rhinitis; allergic perennial rhinitis; house dust mite; pediatric perennial rhinitis; sublingual immunotherapy; HOUSE-DUST-MITE; ALLERGIC RHINITIS; DOUBLE-BLIND; PEDIATRIC-PATIENTS; SUBCUTANEOUS IMMUNOTHERAPY; PUBLICATION BIAS; EFFICACY; ASTHMA; SAFETY; PREVALENCE;
D O I
10.1002/alr.22589
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background Allergic rhinitis (AR) is a major public health problem and is increasing worldwide. AR affects children's learning efficiency, sleep quality, and other major aspects of life. Sublingual immunotherapy (SLIT) is effective and safe for children with seasonal AR, but for children with perennial allergic rhinitis (PAR) caused by house dust mites (HDM), its effectiveness and safety is less convincing. Methods Medical literature databases up to 2019 were searched for published and unpublished pieces of evidence. Studies were individually screened by 2 reviewers against the eligibility criteria. Primary outcomes were total nasal symptoms scores (TNSS) and total medication scores (TMS). The secondary outcomes were total ocular symptoms scores and adverse events (AEs). Random effect models and fixed-effect models were used to calculate the standard mean difference (SMD) and risk ratio (RR), respectively. Results We identified 3772 abstracts, of which only 16 studies met our established criteria. SLIT significantly reduced TNSS (SMD -1.73; 95% CI, -2.62 to -0.84;p= 0.0001) and TMS (SMD -1.21; 95% CI, -1.75 to -0.67;p< 0.00001). Compared with children taking placebo, children taking SLIT were 1.08 (95% CI, 1 to 1.17;p= 0.05), 1.15 (95% CI, 0.87 to 1.51;p= 0.32), and 1.68 (95% CI, 0.68 to 4.11;p= 0.26) times more likely to develop mild, moderate, and severe AEs, respectively. Conclusion HDM SLIT can effectively alleviate TNSS and TMS in children with PAR, but care should be taken to avoid harm due to possible adverse drug reactions.
引用
收藏
页码:1226 / 1235
页数:10
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