PMID- 23315962
OWN - NLM
STAT- MEDLINE
DCOM- 20140211
LR  - 20181202
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Linking)
VI  - 3
IP  - 7
DP  - 2013 Jul
TI  - Subcutaneous immunotherapy for allergic rhinitis: an evidence based review of the 
      recent literature with recommendations.
PG  - 519-31
LID - 10.1002/alr.21141 [doi]
AB  - BACKGROUND: Allergic rhinitis is a common allergic disease with increasing 
      prevalence in Western Societies. Medical therapy is first line treatment, and is 
      aimed at reducing symptoms of immunoglobulin E (IgE)-mediated inflammation of the 
      nasal passages. In patients with disease refractory to medical therapy, 
      subcutaneous immunotherapy is an option. The aim of this study is to update a 
      recent Cochrane review with available level 1 evidence for seasonal and perennial 
      allergic rhinitis. METHODS: A systematic review of the literature was performed 
      from 2006 to 2011 and compared with data from a 2007 Cochrane review on 
      immunotherapy for seasonal allergic rhinitis. We included all studies of level 1 
      evidence. All forms of single extract immunotherapy were considered. Studies with 
      primary asthma related end-points were excluded. Primary end-points were 
      instruments of clinical efficacy (ie, symptom-medication scores) and adverse 
      events. RESULTS: We retrieved 12 level 1 studies for review. In total, 1512 
      patients were randomized into treatment groups, alternative study groups 
      (alternative duration of therapy or sublingual immunotherapy [SLIT]), or placebo. 
      Efficacy was evaluated based on reported symptom and/or medication score, 
      validated quality of life instruments, immunological assays, challenge testing, 
      and adverse events. CONCLUSION: Subcutaneous immunotherapy improves symptom 
      and/or medication scores and validated quality of life measures. In addition, 
      associated changes in surrogate markers of immunologic protection are observed. 
      Subcutaneous immunotherapy is safe when administered to carefully selected 
      patients and in settings capable of responding to systemic reactions. 
      Subcutaneous immunotherapy is recommended for patients with seasonal or perennial 
      allergic rhinitis not responsive to conservative medical therapy, and whose 
      symptoms significantly affect quality of life.
CI  - (c) 2013 ARS-AAOA, LLC.
FAU - Purkey, Michael T
AU  - Purkey MT
AD  - Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA 
      19104, USA. michael.purkey@uphs.upenn.edu
FAU - Smith, Timothy L
AU  - Smith TL
FAU - Ferguson, Berrylin J
AU  - Ferguson BJ
FAU - Luong, Amber
AU  - Luong A
FAU - Reisacher, William R
AU  - Reisacher WR
FAU - Pillsbury, Harold C 3rd
AU  - Pillsbury HC 3rd
FAU - Toskala, Elina
AU  - Toskala E
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20130111
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
RN  - 0 (Immunoglobulins)
SB  - IM
MH  - *Desensitization, Immunologic/adverse effects
MH  - Humans
MH  - Immunoglobulins/immunology
MH  - Quality of Life
MH  - Rhinitis, Allergic
MH  - Rhinitis, Allergic, Perennial/immunology/*therapy
MH  - Symptom Assessment
OTO - NOTNLM
OT  - adverse effects
OT  - allergen administration and dosage
OT  - allergic rhinitis
OT  - desensitization
OT  - immunology
OT  - pollen
OT  - randomized controlled trials
OT  - seasonal therapy
OT  - subcutaneous immunotherapy
EDAT- 2013/01/15 06:00
MHDA- 2014/02/12 06:00
CRDT- 2013/01/15 06:00
PHST- 2011/06/12 00:00 [received]
PHST- 2012/10/22 00:00 [revised]
PHST- 2012/11/01 00:00 [accepted]
PHST- 2013/01/15 06:00 [entrez]
PHST- 2013/01/15 06:00 [pubmed]
PHST- 2014/02/12 06:00 [medline]
AID - 10.1002/alr.21141 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2013 Jul;3(7):519-31. doi: 10.1002/alr.21141. Epub 2013 
      Jan 11.