Telia A A, Telia A Z, Machavariani K, Telia Z
Tbilisi State Medical University, Department of Allergology and Clinical Immunology, Georgia.
Georgian Med News. 2018 Mar(276):123-130.
The purpose of our study was to perform a meta-analysis and thus, based on original randomized placebo-controlled studies, evaluate the effectiveness and safety of sublingual immunotherapy (SLIT) in children and adults suffering from allergic bronchial asthma and rhinitis. On the MEDLINE, EMBASE, LILACS and SCOPUS web pages, the corresponding experimental works were searched. After an expert evaluation, 58 case-studies were selected 38. Of these, 30 concerned the efficacy and safety of sublingual immunotherapy of allergic rhinitis, and 8 of bronchial asthma. In active groups, 347 patients with asthma and 1888 rhinitis were involved, and in the control groups, respectively, 332 and 1795 subjects studied. There were 7 different meta-analytical comparisons based on the purpose of our study. Our Meta-analytic study on the selected publications have been shown that sublingual immunotherapy in children and adults suffering from allergic bronchial asthma and rhinitis is effective and safe. However, based on the low evidentiary level and high heterogeneity of the publication that we used in the meta-analysis, unambiguous recommendations regarding the advisability of using the sublingual immunotherapy method in patients with allergic rhinitis and asthma are premature. For all these reasons, the results of this analysis should be interpreted by the various selected population subgroups, following specific recommendations addressed to unified results, endpoints, time points, measurement scales and dosages, treatment distribution and power calculation. Despite our results, we believe that there are arguments indicating that SLIT may be a promising direction in the treatment of allergic rhinitis and asthma, but it should not be prescribed regularly to all patients.
我们研究的目的是进行一项荟萃分析，从而基于原始随机安慰剂对照研究，评估舌下免疫疗法（SLIT）对患有过敏性支气管哮喘和鼻炎的儿童及成人的有效性和安全性。在MEDLINE、EMBASE、LILACS和SCOPUS网页上搜索了相应的实验作品。经过专家评估，选择了58项案例研究。其中，30项涉及过敏性鼻炎舌下免疫疗法的疗效和安全性，8项涉及支气管哮喘。在治疗组中，纳入了347例哮喘患者和1888例鼻炎患者，在对照组中，分别有332例和1795例受试者参与研究。基于我们的研究目的，进行了7种不同的荟萃分析比较。我们对所选出版物的荟萃分析研究表明，舌下免疫疗法对患有过敏性支气管哮喘和鼻炎的儿童及成人是有效且安全的。然而，基于我们在荟萃分析中使用的出版物证据水平低且异质性高，就过敏性鼻炎和哮喘患者使用舌下免疫疗法的适用性给出明确建议还为时过早。出于所有这些原因，应按照针对统一结果、终点、时间点、测量量表和剂量、治疗分配及功效计算的具体建议，由各个选定的人群亚组来解读该分析结果。尽管有我们的研究结果，但我们认为有论据表明，舌下免疫疗法可能是治疗过敏性鼻炎和哮喘的一个有前景的方向，但不应常规性地开给所有患者。
