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Inmunoterapia sublingual para la rinitis alérgica

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Sublingual immunotherapy for allergic rhinitis

As many as 4 people in every 10 are affected by allergic rhinitis, with immunotherapy providing one of the treatment options. Duncan Wilson, from Queen Elizabeth Hospital in Birmingham England is part of a team that have updated a relevant Cochrane Review.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 1

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Funnel plot of comparison: 1 SLIT versus placebo ‐ all, outcome: 1.1 Allergic rhinitis symptom scores.
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Figure 3

Funnel plot of comparison: 1 SLIT versus placebo ‐ all, outcome: 1.1 Allergic rhinitis symptom scores.

Funnel plot of comparison: 1 SLIT versus placebo ‐ all, outcome: 1.2 Medication scores.
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Figure 4

Funnel plot of comparison: 1 SLIT versus placebo ‐ all, outcome: 1.2 Medication scores.

Comparison 1 SLIT versus placebo ‐ all, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 1.1

Comparison 1 SLIT versus placebo ‐ all, Outcome 1 Allergic rhinitis symptom scores.

Comparison 1 SLIT versus placebo ‐ all, Outcome 2 Medication scores.
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Analysis 1.2

Comparison 1 SLIT versus placebo ‐ all, Outcome 2 Medication scores.

Comparison 2 SLIT versus placebo ‐ seasonal allergen, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 2.1

Comparison 2 SLIT versus placebo ‐ seasonal allergen, Outcome 1 Allergic rhinitis symptom scores.

Comparison 2 SLIT versus placebo ‐ seasonal allergen, Outcome 2 Medication scores.
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Analysis 2.2

Comparison 2 SLIT versus placebo ‐ seasonal allergen, Outcome 2 Medication scores.

Comparison 3 SLIT versus placebo ‐ perennial allergen, Outcome 1 Allergic rhinitis symptom scores.
Figuras y tablas -
Analysis 3.1

Comparison 3 SLIT versus placebo ‐ perennial allergen, Outcome 1 Allergic rhinitis symptom scores.

Comparison 3 SLIT versus placebo ‐ perennial allergen, Outcome 2 Medication scores.
Figuras y tablas -
Analysis 3.2

Comparison 3 SLIT versus placebo ‐ perennial allergen, Outcome 2 Medication scores.

Comparison 4 SLIT versus placebo ‐ adults, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 4.1

Comparison 4 SLIT versus placebo ‐ adults, Outcome 1 Allergic rhinitis symptom scores.

Comparison 4 SLIT versus placebo ‐ adults, Outcome 2 Medication scores.
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Analysis 4.2

Comparison 4 SLIT versus placebo ‐ adults, Outcome 2 Medication scores.

Comparison 5 SLIT versus placebo ‐ children, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 5.1

Comparison 5 SLIT versus placebo ‐ children, Outcome 1 Allergic rhinitis symptom scores.

Comparison 5 SLIT versus placebo ‐ children, Outcome 2 Medication scores.
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Analysis 5.2

Comparison 5 SLIT versus placebo ‐ children, Outcome 2 Medication scores.

Comparison 6 SLIT versus placebo < 6 months, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 6.1

Comparison 6 SLIT versus placebo < 6 months, Outcome 1 Allergic rhinitis symptom scores.

Comparison 6 SLIT versus placebo < 6 months, Outcome 2 Medication scores.
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Analysis 6.2

Comparison 6 SLIT versus placebo < 6 months, Outcome 2 Medication scores.

Comparison 7 SLIT versus placebo 6 to 12 months, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 7.1

Comparison 7 SLIT versus placebo 6 to 12 months, Outcome 1 Allergic rhinitis symptom scores.

Comparison 7 SLIT versus placebo 6 to 12 months, Outcome 2 Medication scores.
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Analysis 7.2

Comparison 7 SLIT versus placebo 6 to 12 months, Outcome 2 Medication scores.

Comparison 8 SLIT versus placebo > 12 months, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 8.1

Comparison 8 SLIT versus placebo > 12 months, Outcome 1 Allergic rhinitis symptom scores.

Comparison 8 SLIT versus placebo > 12 months, Outcome 2 Medication scores.
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Analysis 8.2

Comparison 8 SLIT versus placebo > 12 months, Outcome 2 Medication scores.

Comparison 9 Major allergen content < 5 mcg, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 9.1

Comparison 9 Major allergen content < 5 mcg, Outcome 1 Allergic rhinitis symptom scores.

Comparison 9 Major allergen content < 5 mcg, Outcome 2 Medication scores.
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Analysis 9.2

Comparison 9 Major allergen content < 5 mcg, Outcome 2 Medication scores.

Comparison 10 Major allergen content 5 to 20 mcg, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 10.1

Comparison 10 Major allergen content 5 to 20 mcg, Outcome 1 Allergic rhinitis symptom scores.

Comparison 10 Major allergen content 5 to 20 mcg, Outcome 2 Medication scores.
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Analysis 10.2

Comparison 10 Major allergen content 5 to 20 mcg, Outcome 2 Medication scores.

Comparison 11 Major allergen content > 20 mcg, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 11.1

Comparison 11 Major allergen content > 20 mcg, Outcome 1 Allergic rhinitis symptom scores.

Comparison 11 Major allergen content > 20 mcg, Outcome 2 Medication scores.
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Analysis 11.2

Comparison 11 Major allergen content > 20 mcg, Outcome 2 Medication scores.

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 1 IgE levels ‐ post‐treatment.
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Analysis 12.1

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 1 IgE levels ‐ post‐treatment.

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 2 IgG levels ‐ post‐treatment.
Figuras y tablas -
Analysis 12.2

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 2 IgG levels ‐ post‐treatment.

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 3 IgG4 levels‐ post‐treatment.
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Analysis 12.3

Comparison 12 SLIT versus placebo ‐ immunoglobulins, Outcome 3 IgG4 levels‐ post‐treatment.

Comparison 13 SLIT v placebo ‐ house dust mite, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 13.1

Comparison 13 SLIT v placebo ‐ house dust mite, Outcome 1 Allergic rhinitis symptom scores.

Comparison 13 SLIT v placebo ‐ house dust mite, Outcome 2 Medication scores.
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Analysis 13.2

Comparison 13 SLIT v placebo ‐ house dust mite, Outcome 2 Medication scores.

Comparison 14 SLIT versus placebo ‐ grass pollen, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 14.1

Comparison 14 SLIT versus placebo ‐ grass pollen, Outcome 1 Allergic rhinitis symptom scores.

Comparison 14 SLIT versus placebo ‐ grass pollen, Outcome 2 Medication scores.
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Analysis 14.2

Comparison 14 SLIT versus placebo ‐ grass pollen, Outcome 2 Medication scores.

Comparison 15 SLIT versus placebo ‐ ragweed, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 15.1

Comparison 15 SLIT versus placebo ‐ ragweed, Outcome 1 Allergic rhinitis symptom scores.

Comparison 15 SLIT versus placebo ‐ ragweed, Outcome 2 Medication scores.
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Analysis 15.2

Comparison 15 SLIT versus placebo ‐ ragweed, Outcome 2 Medication scores.

Comparison 16 SLIT versus placebo ‐ Parietaria, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 16.1

Comparison 16 SLIT versus placebo ‐ Parietaria, Outcome 1 Allergic rhinitis symptom scores.

Comparison 16 SLIT versus placebo ‐ Parietaria, Outcome 2 Medication scores.
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Analysis 16.2

Comparison 16 SLIT versus placebo ‐ Parietaria, Outcome 2 Medication scores.

Comparison 17 SLIT versus placebo ‐ tree, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 17.1

Comparison 17 SLIT versus placebo ‐ tree, Outcome 1 Allergic rhinitis symptom scores.

Comparison 17 SLIT versus placebo ‐ tree, Outcome 2 Medication scores.
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Analysis 17.2

Comparison 17 SLIT versus placebo ‐ tree, Outcome 2 Medication scores.

Comparison 18 Allergen sensitivity, Outcome 1 Skin reactivity after treatment.
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Analysis 18.1

Comparison 18 Allergen sensitivity, Outcome 1 Skin reactivity after treatment.

Comparison 18 Allergen sensitivity, Outcome 2 Nasal reactivity after treatment.
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Analysis 18.2

Comparison 18 Allergen sensitivity, Outcome 2 Nasal reactivity after treatment.

Comparison 19 Quality of life, Outcome 1 Adults.
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Analysis 19.1

Comparison 19 Quality of life, Outcome 1 Adults.

Comparison 20 SLIT versus placebo ‐ tablets, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 20.1

Comparison 20 SLIT versus placebo ‐ tablets, Outcome 1 Allergic rhinitis symptom scores.

Comparison 20 SLIT versus placebo ‐ tablets, Outcome 2 Medication scores.
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Analysis 20.2

Comparison 20 SLIT versus placebo ‐ tablets, Outcome 2 Medication scores.

Comparison 21 SLIT versus placebo ‐ drops, Outcome 1 Allergic rhinitis symptom scores.
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Analysis 21.1

Comparison 21 SLIT versus placebo ‐ drops, Outcome 1 Allergic rhinitis symptom scores.

Comparison 21 SLIT versus placebo ‐ drops, Outcome 2 Medication scores.
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Analysis 21.2

Comparison 21 SLIT versus placebo ‐ drops, Outcome 2 Medication scores.

Table 1. Adverse events: data not suitable for analysis

Study ID

Sublingual immunotherapy

Placebo

Additional comments

N

N

Bowen 2004

43

40

Report by SOC

Casanovas 1994

9

6

Grading according to EAACI

Cao 2007

85

91

Insufficient data

Dahl 2006a

61

32

AE reported as percentage of patients

de Blay 2003

33

42

AE reported as percentage of patients

Di Rienzo 2006

19

15

Insufficient data

Drachenberg 2001

49

19

AE reported as difference between SLIT and placebo group (P values)

Dubakiene 2003

59

60

Insufficient data

Durham 2006

 

 

AE reported by severity

Feliziani 1995

18

16

Insufficient data

Guez 2000

36

36

Insufficient data

Hirsch 1997

15

15

Insufficient data

Hordijk 1998

27

30

AE reported SOC

Ippoliti 2003

47

39

Insufficient data

Lima 2002

28

28

Data reported in percentages

Malling 2005

36

11

Trial design

Data reported in percentages

Marcucci 2005

13

11

Insufficient data

Mungan 1999

15

11

Insufficient data

Ott 2009

142

67

Insufficient data

Palma Carlos 2006

17

16

Insufficient data

Panzner 2008

20

15

Insufficient data

Passalacqua 1998

10

10

Insufficient data

Sanchez 2001

20

20

Insufficient data

Tari 1990

34

32

Insufficient data

Voltolini 2001

15

15

Insufficient data

Figuras y tablas -
Table 1. Adverse events: data not suitable for analysis
Table 2. No adverse events reported

Study ID

Sublingual immunotherapy

Placebo

N

N

Ariano 2001

10

10

Bahceciler 2001

8

7

D'Ambrosio 1999

14

16

Passalacqua 1998

15

15

Passalacqua 1999

15

15

Pradalier 1999

63

63

Figuras y tablas -
Table 2. No adverse events reported
Table 3. Adverse events ‐ local reactions

Type of reaction

No of studies reported the event

Sublingual immunotherapy

Placebo

Total No of patients

Total No of events

Total No of patients

Total No of events

Labial oedema

11

604

55

536

7

Buccal pruritus

21

1126

1798

1075

492

Bucco‐ lingual oedema

8

648

143

606

2

Throat irritation

10

770

243

747

29

Oral ‐ non‐specified

3

68

143

71

24

Non‐specified

3

119

7

116

3

Figuras y tablas -
Table 3. Adverse events ‐ local reactions
Table 4. Adverse events ‐ systemic reactions

Type of reaction

No of studies reported the event

Sublingual immunotherapy

Placebo

Total No of patients

Total No of events

Total No of patients

Total No of events

Urticaria

8

204

7

199

9

Pruritus/rash

10

363

13

222

9

Conjunctivitis

8

262

774

238

786

Rhinitis

16

965

1403

912

1034

Rhino‐conjunctivitis

6

184

60

176

58

Asthma/wheezing

15

488

51

450

42

Cough

8

337

313

304

211

Gastro‐intestinal

20

630

88

561

10

Headache

6

535

70

548

68

Anaphylaxis

6

291

0

288

0

Systemic ‐ non‐specified

5

330

4

36

0

Figuras y tablas -
Table 4. Adverse events ‐ systemic reactions
Table 5. Adverse events leading to treatment discontinuation

Study ID

Sublingual immunotherapy

Placebo

N

n

AE description

N

n

AE description

Andre 2003

53

4

Sublingual burning

Oral pruritus, vomiting, headache

Pruritus, lingual oedema, gastralgia, diarrhoea

Asthma and gastralgia

53

1

Gastralgia

Dahl 2006b

316

5

Angioedema on the base of the tongue

Inferior lip angioedema pharyngeal hyperemia, cough, mild dyspnoea

Pharynx oedema, voice changes

Swelling throat

Angioedema of lips 

318

0

Not applicable

Durham 2006

141

8

Not described

136

1

Not described

Khinchi 2004

23

3

Pain in fingers and visible veins

Gastrointestinal complaints

Itching in the mouth

24

1

Pain and weakness in both arms

La Rosa 1999

20

4

Not described

21

1

Not described

Lima 2002

28

1

Troublesome local side effects

28

0

Not applicable

Malling 2005

12

1

Sting and blisters in the mouth

11

1

Mouth itching

Pajno 2003

15

1

Systemic reaction (abdominal pain, shortness of breath, wheezing)

15

0

Not applicable

Pradalier 1999

63

2

Worsening symptoms

Marked reactions

63

2

Worsening symptoms

Marked reactions

Rolinck‐Werninghaus 2004

49

1

Acute asthma exacerbation needed hospitalisation

48

3

Not described

Smith 2004

44

7

4 patients with systemic but not life‐threatening AE

45

Insufficient data

Tonnel 2004

15

1

Itching/burning of the mouth

17

1

Respiratory tract infection

Vervloet 2006

38

1

Gastric pain and vomiting

38

0

Not applicable

Vourdas 1998

33

1

Worsening of allergic disease

29

0

Not applicable

Voltolini 2001

15

1

Exacerbation of rhinitis and OAS

15

1

Dyspnoea

Figuras y tablas -
Table 5. Adverse events leading to treatment discontinuation
Comparison 1. SLIT versus placebo ‐ all

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

49

4589

Std. Mean Difference (IV, Random, 95% CI)

‐0.49 [‐0.64, ‐0.34]

2 Medication scores Show forest plot

38

3379

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.43, ‐0.21]

Figuras y tablas -
Comparison 1. SLIT versus placebo ‐ all
Comparison 2. SLIT versus placebo ‐ seasonal allergen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

39

4084

Std. Mean Difference (IV, Random, 95% CI)

‐0.34 [‐0.44, ‐0.25]

2 Medication scores Show forest plot

32

3014

Std. Mean Difference (IV, Random, 95% CI)

‐0.30 [‐0.41, ‐0.19]

Figuras y tablas -
Comparison 2. SLIT versus placebo ‐ seasonal allergen
Comparison 3. SLIT versus placebo ‐ perennial allergen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

10

505

Std. Mean Difference (IV, Random, 95% CI)

‐0.93 [‐1.69, ‐0.17]

2 Medication scores Show forest plot

6

365

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.89, 0.02]

Figuras y tablas -
Comparison 3. SLIT versus placebo ‐ perennial allergen
Comparison 4. SLIT versus placebo ‐ adults

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

34

3197

Std. Mean Difference (IV, Random, 95% CI)

‐0.44 [‐0.56, ‐0.31]

2 Medication scores Show forest plot

26

2235

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.53, ‐0.26]

Figuras y tablas -
Comparison 4. SLIT versus placebo ‐ adults
Comparison 5. SLIT versus placebo ‐ children

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

15

1392

Std. Mean Difference (IV, Random, 95% CI)

‐0.52 [‐0.94, ‐0.10]

2 Medication scores Show forest plot

12

1144

Std. Mean Difference (IV, Random, 95% CI)

‐0.16 [‐0.32, 0.00]

Figuras y tablas -
Comparison 5. SLIT versus placebo ‐ children
Comparison 6. SLIT versus placebo < 6 months

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

17

1772

Std. Mean Difference (IV, Random, 95% CI)

‐0.54 [‐0.86, ‐0.21]

2 Medication scores Show forest plot

15

1366

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.45, ‐0.18]

Figuras y tablas -
Comparison 6. SLIT versus placebo < 6 months
Comparison 7. SLIT versus placebo 6 to 12 months

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

16

1736

Std. Mean Difference (IV, Random, 95% CI)

‐0.31 [‐0.46, ‐0.16]

2 Medication scores Show forest plot

13

1398

Std. Mean Difference (IV, Random, 95% CI)

‐0.31 [‐0.50, ‐0.12]

Figuras y tablas -
Comparison 7. SLIT versus placebo 6 to 12 months
Comparison 8. SLIT versus placebo > 12 months

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

16

1089

Std. Mean Difference (IV, Random, 95% CI)

‐0.63 [‐0.92, ‐0.34]

2 Medication scores Show forest plot

10

615

Std. Mean Difference (IV, Random, 95% CI)

‐0.34 [‐0.64, ‐0.04]

Figuras y tablas -
Comparison 8. SLIT versus placebo > 12 months
Comparison 9. Major allergen content < 5 mcg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

8

275

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.69, 0.05]

2 Medication scores Show forest plot

6

219

Std. Mean Difference (IV, Random, 95% CI)

‐0.59 [‐0.94, ‐0.24]

Figuras y tablas -
Comparison 9. Major allergen content < 5 mcg
Comparison 10. Major allergen content 5 to 20 mcg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

12

1972

Std. Mean Difference (IV, Random, 95% CI)

‐0.34 [‐0.45, ‐0.24]

2 Medication scores Show forest plot

11

1940

Std. Mean Difference (IV, Random, 95% CI)

‐0.21 [‐0.35, ‐0.07]

Figuras y tablas -
Comparison 10. Major allergen content 5 to 20 mcg
Comparison 11. Major allergen content > 20 mcg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

12

1041

Std. Mean Difference (IV, Random, 95% CI)

‐0.33 [‐0.49, ‐0.17]

2 Medication scores Show forest plot

10

661

Std. Mean Difference (IV, Random, 95% CI)

‐0.22 [‐0.43, 0.00]

Figuras y tablas -
Comparison 11. Major allergen content > 20 mcg
Comparison 12. SLIT versus placebo ‐ immunoglobulins

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 IgE levels ‐ post‐treatment Show forest plot

14

1334

Std. Mean Difference (IV, Random, 95% CI)

0.27 [‐0.01, 0.55]

2 IgG levels ‐ post‐treatment Show forest plot

3

590

Std. Mean Difference (IV, Random, 95% CI)

0.95 [0.78, 1.12]

3 IgG4 levels‐ post‐treatment Show forest plot

13

1187

Mean Difference (IV, Fixed, 95% CI)

0.46 [0.29, 0.63]

Figuras y tablas -
Comparison 12. SLIT versus placebo ‐ immunoglobulins
Comparison 13. SLIT v placebo ‐ house dust mite

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

9

464

Std. Mean Difference (IV, Random, 95% CI)

‐0.97 [‐1.80, ‐0.13]

2 Medication scores Show forest plot

5

189

Std. Mean Difference (IV, Random, 95% CI)

‐0.52 [‐1.09, 0.05]

Figuras y tablas -
Comparison 13. SLIT v placebo ‐ house dust mite
Comparison 14. SLIT versus placebo ‐ grass pollen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

23

3013

Std. Mean Difference (IV, Random, 95% CI)

‐0.35 [‐0.45, ‐0.24]

2 Medication scores Show forest plot

17

2308

Std. Mean Difference (IV, Random, 95% CI)

‐0.23 [‐0.37, ‐0.10]

Figuras y tablas -
Comparison 14. SLIT versus placebo ‐ grass pollen
Comparison 15. SLIT versus placebo ‐ ragweed

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

2

175

Std. Mean Difference (IV, Random, 95% CI)

‐0.44 [‐0.74, ‐0.14]

2 Medication scores Show forest plot

2

175

Std. Mean Difference (IV, Random, 95% CI)

‐0.30 [‐0.60, ‐0.00]

Figuras y tablas -
Comparison 15. SLIT versus placebo ‐ ragweed
Comparison 16. SLIT versus placebo ‐ Parietaria

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

5

151

Std. Mean Difference (IV, Random, 95% CI)

‐0.36 [‐0.69, ‐0.04]

2 Medication scores Show forest plot

5

151

Std. Mean Difference (IV, Random, 95% CI)

‐0.62 [‐1.00, ‐0.24]

Figuras y tablas -
Comparison 16. SLIT versus placebo ‐ Parietaria
Comparison 17. SLIT versus placebo ‐ tree

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

9

380

Std. Mean Difference (IV, Random, 95% CI)

‐0.42 [‐0.77, ‐0.06]

2 Medication scores Show forest plot

9

380

Std. Mean Difference (IV, Random, 95% CI)

‐0.38 [‐0.62, ‐0.13]

Figuras y tablas -
Comparison 17. SLIT versus placebo ‐ tree
Comparison 18. Allergen sensitivity

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Skin reactivity after treatment Show forest plot

6

331

Std. Mean Difference (IV, Random, 95% CI)

0.12 [‐0.26, 0.51]

2 Nasal reactivity after treatment Show forest plot

7

220

Std. Mean Difference (IV, Random, 95% CI)

0.32 [‐0.13, 0.78]

Figuras y tablas -
Comparison 18. Allergen sensitivity
Comparison 19. Quality of life

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Adults Show forest plot

2

397

Mean Difference (IV, Fixed, 95% CI)

‐0.42 [‐0.73, ‐0.12]

Figuras y tablas -
Comparison 19. Quality of life
Comparison 20. SLIT versus placebo ‐ tablets

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

11

1881

Mean Difference (IV, Fixed, 95% CI)

‐0.48 [‐0.58, ‐0.38]

2 Medication scores Show forest plot

9

1578

Mean Difference (IV, Fixed, 95% CI)

‐0.33 [‐0.46, ‐0.20]

Figuras y tablas -
Comparison 20. SLIT versus placebo ‐ tablets
Comparison 21. SLIT versus placebo ‐ drops

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Allergic rhinitis symptom scores Show forest plot

35

2464

Mean Difference (IV, Fixed, 95% CI)

‐0.35 [‐0.42, ‐0.28]

2 Medication scores Show forest plot

27

1653

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.05, 0.04]

Figuras y tablas -
Comparison 21. SLIT versus placebo ‐ drops