Updating the role played by immunotherapy for allergic rhinitis: meta-analysis

Abstract

BackgroundAlthough the effectiveness of allergen monotherapy immunotherapy for allergic rhinitis (AR) has been well established by many prior studies, other aspects of immunotherapy are still incompletely documented by high-quality studies. The many published papers describe various results. The aim of the present study was to conduct a meta-analysis on the effectiveness of allergen immunotherapy. MethodsA total of 56 homogeneous studies were included in the analysis. The inclusion criteria used to select articles were as follows: (1) placebo-controlled clinical trials; (2) the use of immunotherapy; (3) participants and/or physicians were or were not blinded to immunotherapy or placebo assignment (single-blinding, double-blinding, or no-blinding studies); and (4) randomization or not of those in the immunotherapy and placebo groups. ResultsBetween 2003 and 2013, 114 placebo-controlled clinical trials were reported in Medline. Studies describing recovery rates in immunotherapy and placebo groups numbered 56. The distribution of such works was homogeneous (heterogeneity chi-square = 16.11; degrees of freedom [df] = 55; p = 1.000). The extent of recovery in immunotherapy groups was 53.671-fold greater than in placebo groups (Mantel-Haenszel [M-H] pooled risk ratio [RR] = 53.671; 95% confidence interval [CI], 36.981 to 77.893; z = 20.96; p < 0.001). ConclusionOur meta-analysis suggests that immunotherapy is associated with a recovery rate 53.671-fold that of placebo.