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Author(s): Farraia, M
Paciência, I
Castro Mendes, F
Cavaleiro Rufo, J
Shamji, M
Agache, I
Moreira, A
Title: Allergen immunotherapy for asthma prevention: A systematic review and meta-analysis of randomized and non-randomized controlled studies
Publisher: Wiley
Issue Date: 2022
Abstract: Background: Allergen immunotherapy (AIT) is a disease-modifying treatment for IgE-mediated diseases. Randomized controlled trials (RCTs) support AIT's potential role in asthma prevention but evidence from non-randomized studies of interventions (NRSI) and longitudinal observational studies has been poorly addressed. Therefore, we aimed to conduct a systematic review and meta-analysis to assess clinical data from all study types to evaluate quantitatively the preventive role of AIT in asthma onset. Methods: We search three databases. Studies were screened, selected and evaluated for quality using risk-of-bias (ROB) tools. Data were descriptively summarized and meta-analysed using random effects. We performed a sensitivity, influence and subgroup analyses. Publication bias and heterogeneity were assessed. Results: From the 4549 identified studies, 24 (12 RCTs and 12 NRSI) were included in the qualitative synthesis and 18 underwent meta-analysis. One study was at low ROB, seven had moderate ROB, and 15 were proven of high ROB. Random-effects analysis showed a significant decrease in the risk of developing asthma following AIT by 25% (RR, 95% CI: 0.75, 0.64–0.88). This effect was not significant in the sensitivity analysis. Publication bias raised concerns, together with the moderate heterogeneity between studies (I2 = 58%). Subgroup analysis showed a remarkable preventive effect of AIT in children (RR, 95% CI: 0.71, 0.53–0.96), when completing 3 years of therapy (RR, 95% CI: 0.64, 0.47–0.88), and in mono-sensitized patients (RR, 95% CI: 0.49, 0.39–0.61). Conclusions: Our findings support a possible preventive effect of AIT in asthma onset and suggest an enhanced effect when administered in children, mono-sensitized, and for at least 3 years, independently of allergen type. © 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Subject: allergen immunotherapy; allergy treament; asthma; prevention; rhinitis
Source: Allergy. 2022 Jun;77(6):1719-1735. doi: 10.1111/all.15295. Epub 2022 Apr 2.
Related Information: info:eu-repo/grantAgreement/FCT/POR_NORTE/SFRH/BD/145168/2019/PT
info:eu-repo/grantAgreement/FCT/CEEC IND 3ed/2020.01350.CEECIND/CP1623/CT0001/PT
Document Type: Artigo em Revista Científica Internacional
Rights: openAccess
Appears in Collections:ISPUP - Artigo em Revista Científica Internacional

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