The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis
EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis
Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis.

Methods: We searched nine international biomedical databases for published, inprogress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses.

Results: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD 0.53, 95% CI 0.63, 0.42), medication (SMD 0.37, 95% CI 0.49, 0.26), and combined symptom and medication (SMD 0.49, 95% CI 0.69, 0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores.

Conclusions: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy.
0105-4538
Roberts, G.
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Pfaar, O.
e3f9b5dc-2e6d-4526-8a61-29024ff1c4b4
Akdis, C.A.
748a7761-0c9a-4ed7-b4fe-b4d42d5d0da6
Ansotegui, I.J.
00ff36f2-6ba0-48eb-86e5-763adb982117
Durham, S.R.
99964123-7d76-411f-94d6-fbddfb1840c8
Gerth van Wijk, R.
64d21a3b-ed5a-46ae-a2d2-35478f0ea484
Halken, S.
6204ce6f-7b6e-4041-9da2-a5f250467fbb
Larenas-Linnemann, D.
2534965d-a0f1-494d-8e9e-7f10eabd4cd8
Pawankar, R.
f2b8947d-1472-4b08-8dfb-2d2384be0108
Pitsios, C.
8375fe9d-4e41-4b7f-a8c9-aa4680c2fb0f
Sheikh, A.
f34621ac-f425-42fd-81e3-2057b1c9ce2f
Worm, M.
8615925e-dcd9-4e23-867f-2c4eaeea2b4c
Arasi, S.
75020cc5-43aa-4bd3-b143-838c5f37585a
Calderon, M.A.
338bcaf9-5912-496c-b0ba-07e8344064ec
Cingi, C.
3ea6ba13-f0a8-470d-820c-22ea20fcf252
Dhami, S.
7f99a6f6-af35-41f5-9a50-d132d09e191e
Fauquert, J.-L.
b0cd37b4-a63b-4e09-9154-ff1c5ac368e0
Hamelmann, E.
85a0e5d2-f6c8-44f3-8d08-78437838a072
Hellings, P.W.
19f5408b-5d49-4035-8923-dd574e535e8f
Jacobsen, L.
62969f94-18f8-44a3-b718-b85d174fa7fd
Knol, E.
fc7baaa1-c167-4d3c-a5fe-5d7fa6a7a26e
Lin, S.Y.
b7b37f3e-20b0-4725-8a80-2b0b903cc1b8
Maggina, P.
d09834ce-123a-4fb4-8854-2d8406a8d79e
Mosges, R.
7d0940c1-67c1-4609-ab86-b729e433891e
Elberink, J.N.G. Oude
b4d4a63b-896c-414c-ab66-e7ddcdee02cd
Pajno, G.B.
9b1aefd0-c949-4a4d-ad62-51a0b151dd7a
Pastorello, E.
1991908f-297f-4412-b17c-7c62d63cd42c
Penagos, M.
9bb620df-326f-478b-93eb-f8f4ff7b6984
Rotiroti, G.
4ac097e6-01cf-449a-a493-d41d8bfb2e0f
Schmidt-Weber, C.B.
1bbdced2-957f-4b8f-a45c-fa0ebb25a044
Timmermans, F.
470d64f1-850f-4413-8dc6-7681f67ba3cf
Tsilochristou, O.
bfbb0eaa-4108-4d42-a5d9-d7fad63a28df
Varga, E.-M.
6a07ade9-ef21-4173-9384-51d9efe8ba84
Wilkinson, J.N.
7dd7efed-af30-41fd-b5a1-5f4b585a07b7
Williams, A.
5906f63e-1283-4a30-9ec1-74d19d61b328
Zhang, L.
1170f035-b8d0-490c-ac24-ee05105011a7
Agache, I.
2c1d12ef-a70a-4395-a5d7-fe3a657044bb
Angier, E.
e8f5d797-d87f-4bac-903d-523ab6924b35
Fernandez-Rivas, M.
ed083572-3435-4946-87d3-405a63ddd679
Jutel, M.
754b883c-2636-43e0-83f0-764b4bac754c
Lau, S.
f9e1fe62-a3e1-4178-a9a0-7e650a307445
Van Ree, R.
4100f8ce-ece6-4ab0-9a4f-e0e862ef078d
Ryan, D.
589805c9-f59f-44d3-a2b1-7924e9566612
Sturm, G.
cea98725-faa3-4f41-afa4-87280ab4dda7
Muraro, A.
31a2d167-86e1-4e11-87ad-6ffb7e32cd47
Roberts, G.
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Pfaar, O.
e3f9b5dc-2e6d-4526-8a61-29024ff1c4b4
Akdis, C.A.
748a7761-0c9a-4ed7-b4fe-b4d42d5d0da6
Ansotegui, I.J.
00ff36f2-6ba0-48eb-86e5-763adb982117
Durham, S.R.
99964123-7d76-411f-94d6-fbddfb1840c8
Gerth van Wijk, R.
64d21a3b-ed5a-46ae-a2d2-35478f0ea484
Halken, S.
6204ce6f-7b6e-4041-9da2-a5f250467fbb
Larenas-Linnemann, D.
2534965d-a0f1-494d-8e9e-7f10eabd4cd8
Pawankar, R.
f2b8947d-1472-4b08-8dfb-2d2384be0108
Pitsios, C.
8375fe9d-4e41-4b7f-a8c9-aa4680c2fb0f
Sheikh, A.
f34621ac-f425-42fd-81e3-2057b1c9ce2f
Worm, M.
8615925e-dcd9-4e23-867f-2c4eaeea2b4c
Arasi, S.
75020cc5-43aa-4bd3-b143-838c5f37585a
Calderon, M.A.
338bcaf9-5912-496c-b0ba-07e8344064ec
Cingi, C.
3ea6ba13-f0a8-470d-820c-22ea20fcf252
Dhami, S.
7f99a6f6-af35-41f5-9a50-d132d09e191e
Fauquert, J.-L.
b0cd37b4-a63b-4e09-9154-ff1c5ac368e0
Hamelmann, E.
85a0e5d2-f6c8-44f3-8d08-78437838a072
Hellings, P.W.
19f5408b-5d49-4035-8923-dd574e535e8f
Jacobsen, L.
62969f94-18f8-44a3-b718-b85d174fa7fd
Knol, E.
fc7baaa1-c167-4d3c-a5fe-5d7fa6a7a26e
Lin, S.Y.
b7b37f3e-20b0-4725-8a80-2b0b903cc1b8
Maggina, P.
d09834ce-123a-4fb4-8854-2d8406a8d79e
Mosges, R.
7d0940c1-67c1-4609-ab86-b729e433891e
Elberink, J.N.G. Oude
b4d4a63b-896c-414c-ab66-e7ddcdee02cd
Pajno, G.B.
9b1aefd0-c949-4a4d-ad62-51a0b151dd7a
Pastorello, E.
1991908f-297f-4412-b17c-7c62d63cd42c
Penagos, M.
9bb620df-326f-478b-93eb-f8f4ff7b6984
Rotiroti, G.
4ac097e6-01cf-449a-a493-d41d8bfb2e0f
Schmidt-Weber, C.B.
1bbdced2-957f-4b8f-a45c-fa0ebb25a044
Timmermans, F.
470d64f1-850f-4413-8dc6-7681f67ba3cf
Tsilochristou, O.
bfbb0eaa-4108-4d42-a5d9-d7fad63a28df
Varga, E.-M.
6a07ade9-ef21-4173-9384-51d9efe8ba84
Wilkinson, J.N.
7dd7efed-af30-41fd-b5a1-5f4b585a07b7
Williams, A.
5906f63e-1283-4a30-9ec1-74d19d61b328
Zhang, L.
1170f035-b8d0-490c-ac24-ee05105011a7
Agache, I.
2c1d12ef-a70a-4395-a5d7-fe3a657044bb
Angier, E.
e8f5d797-d87f-4bac-903d-523ab6924b35
Fernandez-Rivas, M.
ed083572-3435-4946-87d3-405a63ddd679
Jutel, M.
754b883c-2636-43e0-83f0-764b4bac754c
Lau, S.
f9e1fe62-a3e1-4178-a9a0-7e650a307445
Van Ree, R.
4100f8ce-ece6-4ab0-9a4f-e0e862ef078d
Ryan, D.
589805c9-f59f-44d3-a2b1-7924e9566612
Sturm, G.
cea98725-faa3-4f41-afa4-87280ab4dda7
Muraro, A.
31a2d167-86e1-4e11-87ad-6ffb7e32cd47

Roberts, G., Pfaar, O., Akdis, C.A., Ansotegui, I.J., Durham, S.R., Gerth van Wijk, R., Halken, S., Larenas-Linnemann, D., Pawankar, R., Pitsios, C., Sheikh, A., Worm, M., Arasi, S., Calderon, M.A., Cingi, C., Dhami, S., Fauquert, J.-L., Hamelmann, E., Hellings, P.W., Jacobsen, L., Knol, E., Lin, S.Y., Maggina, P., Mosges, R., Elberink, J.N.G. Oude, Pajno, G.B., Pastorello, E., Penagos, M., Rotiroti, G., Schmidt-Weber, C.B., Timmermans, F., Tsilochristou, O., Varga, E.-M., Wilkinson, J.N., Williams, A., Zhang, L., Agache, I., Angier, E., Fernandez-Rivas, M., Jutel, M., Lau, S., Van Ree, R., Ryan, D., Sturm, G. and Muraro, A. (2017) EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. (doi:10.1111/all.13317).

Record type: Article

Abstract

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis.

Methods: We searched nine international biomedical databases for published, inprogress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses.

Results: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD 0.53, 95% CI 0.63, 0.42), medication (SMD 0.37, 95% CI 0.49, 0.26), and combined symptom and medication (SMD 0.49, 95% CI 0.69, 0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores.

Conclusions: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy.

This record has no associated files available for download.

More information

Accepted/In Press date: 20 September 2017
e-pub ahead of print date: 30 October 2017

Identifiers

Local EPrints ID: 417285
URI: http://eprints.soton.ac.uk/id/eprint/417285
ISSN: 0105-4538
PURE UUID: 8269b84b-685f-4196-ac64-91663f1c827e
ORCID for G. Roberts: ORCID iD orcid.org/0000-0003-2252-1248

Catalogue record

Date deposited: 26 Jan 2018 17:31
Last modified: 26 Nov 2021 02:49

Export record

Altmetrics

Contributors

Author: G. Roberts ORCID iD
Author: O. Pfaar
Author: C.A. Akdis
Author: I.J. Ansotegui
Author: S.R. Durham
Author: R. Gerth van Wijk
Author: S. Halken
Author: D. Larenas-Linnemann
Author: R. Pawankar
Author: C. Pitsios
Author: A. Sheikh
Author: M. Worm
Author: S. Arasi
Author: M.A. Calderon
Author: C. Cingi
Author: S. Dhami
Author: J.-L. Fauquert
Author: E. Hamelmann
Author: P.W. Hellings
Author: L. Jacobsen
Author: E. Knol
Author: S.Y. Lin
Author: P. Maggina
Author: R. Mosges
Author: J.N.G. Oude Elberink
Author: G.B. Pajno
Author: E. Pastorello
Author: M. Penagos
Author: G. Rotiroti
Author: C.B. Schmidt-Weber
Author: F. Timmermans
Author: O. Tsilochristou
Author: E.-M. Varga
Author: J.N. Wilkinson
Author: A. Williams
Author: L. Zhang
Author: I. Agache
Author: E. Angier
Author: M. Fernandez-Rivas
Author: M. Jutel
Author: S. Lau
Author: R. Van Ree
Author: D. Ryan
Author: G. Sturm
Author: A. Muraro

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×