Medical College of Georgia at Augusta University, Augusta, Ga.
National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital London, London, United Kingdom.
J Allergy Clin Immunol Pract. 2024 Jun;12(6):1520-1529.e5. doi: 10.1016/j.jaip.2024.01.038. Epub 2024 Feb 1.
Allergic rhinitis with or without conjunctivitis can negatively impact many aspects of quality of life (QoL). The efficacy and safety of standardized quality (SQ) sublingual immunotherapy (SLIT) tablets have been confirmed across large clinical trials in adults with grass, tree, ragweed, and house dust mite (HDM) allergic rhinitis with or without conjunctivitis.
This pooled analysis investigates whether the reduction in symptom burden found across the clinical trials is supported by improvements in QoL.
A total of 11 phase II/III randomized placebo-controlled trials across the SQ grass, tree, ragweed, and HDM SLIT tablets (grass: N = 3179; ragweed: N = 767; tree: N = 634; HDM: N = 2221) were included. QoL was assessed using the standardized Rhinitis Quality of Life Questionnaire (RQLQ), with the exception of 3 grass trials, which used the nonstandardized version. The overall RQLQ scores were expressed as a mean of 7 domains. In the pooled analysis, treatment was used as fixed effect; and the trial, and the interaction between region/country and trial as random effects.
The pooled analysis showed consistent and statistically significant improvements in overall RQLQ scores across all 4 SQ SLIT tablets versus placebo (pooled estimate [95% CI], P value-grass: -0.20 [-0.28 to -0.12], P < .001; tree: -0.42 [-0.58 to -0.26], P < .001; ragweed: -0.36 [-0.55 to -0.17], P < .001; HDM: -0.28 [-0.39 to -0.17], P < .001). Furthermore, significant improvements versus placebo for all 4 SQ SLIT tablets were seen across the 7 individual domains.
The proven efficacy of SQ SLIT tablets to reduce symptoms across 4 of the most common respiratory allergens is supported by concurrent significant improvements in RQLQ scores overall and for all 7 domains.
过敏性鼻炎伴或不伴结膜炎会对生活质量（QoL）的多个方面产生负面影响。标准化质量（SQ）舌下免疫疗法（SLIT）片剂在成人花粉、树木、豚草和屋尘螨（HDM）过敏性鼻炎伴或不伴结膜炎的大型临床试验中已被证实具有疗效和安全性。
本汇总分析旨在探讨临床试验中发现的症状负担减轻是否得到生活质量改善的支持。
共纳入了 11 项 SQ 花粉、树木、豚草和 HDM SLIT 片剂的 II/III 期随机安慰剂对照试验（花粉：N=3179；豚草：N=767；树木：N=634；HDM：N=2221）。使用标准化的鼻炎生活质量问卷（RQLQ）评估生活质量，除了 3 项花粉试验外，其余均使用非标准化版本。汇总分析中，治疗作为固定效应，试验和地区/国家与试验之间的相互作用作为随机效应。
汇总分析显示，与安慰剂相比，所有 4 种 SQ SLIT 片剂在总体 RQLQ 评分上均有一致且具有统计学意义的改善（汇总估计值[95%置信区间]，P 值-花粉：-0.20[-0.28 至-0.12]，P<.001；树木：-0.42[-0.58 至-0.26]，P<.001；豚草：-0.36[-0.55 至-0.17]，P<.001；HDM：-0.28[-0.39 至-0.17]，P<.001）。此外，与安慰剂相比，所有 4 种 SQ SLIT 片剂在 7 个单独的领域均有显著改善。
4 种最常见的呼吸道过敏原的 SQ SLIT 片剂在减轻症状方面的疗效已得到证实，同时在总体和所有 7 个领域的 RQLQ 评分也有显著改善。
