BACKGROUND: The European Academy of @entity566 and Clinical Immunology (EAACI) is developing Guidelines for Allergen Immunotherapy (AIT) for IgE-mediated @entity5419 . To inform the development of clinical recommendations, we sought to critically assess evidence on the effectiveness, safety and cost-effectiveness of AIT in the management of @entity5419 . METHODS: We undertook a systematic review and meta-analysis that involved searching nine international electronic databases for @entity23 ( @entity23 ) and non-randomized studies (NRS). Eligible studies were independently assessed by two reviewers against pre-defined eligibility criteria. The quality of studies was assessed using the Cochrane Risk of Bias tool for @entity23 and the Cochrane ACROBAT-NRS tool for quasi- @entity23 . Random-effects meta-analyses were undertaken, with planned subgroup and sensitivity analyses. RESULTS: We identified 1814 potentially relevant papers from which we selected 31 eligible studies, comprising of 25 @entity23 and six NRS, studying a total of 1259 @entity1 . Twenty-five trials evaluated @entity1697 ( @entity1697 ), five studies investigated @entity13366 ( @entity13366 ) and one study evaluated epicutaneous immunotherapy (EPIT). The majority of these studies were in @entity1 . Twenty-seven studies assessed desensitization and nine studies investigated sustained unresponsiveness post-discontinuation of AIT. Meta-analyses demonstrated a substantial benefit in terms of desensitization (risk ratio (RR)=0.19, 95%CI 0.12, 0.29) and sustained unresponsiveness (RR=0.20, 95%CI 0.10, 0.59). Only one study reported on disease-specific quality of life (QoL), which reported no comparative results between @entity1697 and control group. Meta-analyses revealed that the risk of experiencing a systemic adverse reaction was higher in those receiving AIT, with a more marked increase in the risk of local adverse reactions. Sensitivity analysis excluding those studies judged to be at high risk of bias demonstrated the robustness of summary estimates of effectiveness and safety of AIT for @entity5419 . None of the studies reported data on health economic analyses. CONCLUSIONS: AIT may be effective in raising the threshold of reactivity to a range of foods in @entity1 with IgE-mediated @entity5419 whilst receiving (i.e. desensitization) and post-discontinuation of AIT. It is however associated with a modest increased risk in serious systemic adverse reactions and a substantial increase in minor local adverse reactions. More data are needed in relation to adults, the impact on QoL and the cost-effectiveness of AIT. This article is protected by copyright. All rights reserved.

Allergen immunotherapy for IgE-mediated XXXX : a systematic review and meta-analysis.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity1697 :: ('MESH:D009062', 'Disease') :: ['OIT', 'oral immunotherapy'] @entity5419 :: ('MESH:D005512', 'Disease') :: ['food allergy', 'Food Allergy'] @entity566 :: ('MESH:D006967', 'Disease') :: ['Allergy'] @entity13366 :: ('MESH:D013362', 'Disease') :: ['SLIT', 'sublingual immunotherapy'] @entity23 :: ('MESH:D007174', 'Disease') :: ['randomized controlled trials', 'RCTs']
@entity5419 :: (MESH:D005512,Disease) :: ['food allergy']
