Efficacy evaluation of allergen-specific immunotherapy in children with asthma: a systematic review and meta-analysis.

BACKGROUND

Asthma is the most common chronic respiratory disease in children. Although conventional treatments such as inhaled corticosteroids and long-acting β2-receptor agonists can effectively control symptoms, some children still face the problem of frequent attacks and drug side effects. As a potential etiological treatment, allergen-specific immunotherapy aims to induce immune tolerance by gradually increasing exposure to specific allergens, thereby relieving asthma symptoms in the long term. This meta-analysis aims to synthesize the existing high-quality evidence and systematically review the efficacy of allergen-specific immunotherapy for childhood asthma.

METHODS

We performed literature search, screening, and data extraction according to the Cochrane Collaboration guidelines. A computerized search of PubMed, Embase, Web of Science, Cochrane Central, and CNKI databases was performed, and 10 randomized controlled clinical trials (RCTs) were included. Two independent reviewers screened the literature, extracted data, and assessed the risk of bias according to predefined criteria. The main outcome measures included TASS, TMS, VAS scores, and FEV1%.

RESULTS

A total of 10 RCT studies were included, and all met the inclusion criteria. Meta-analysis results showed that allergen-specific immunotherapy showed a positive effect in improving the symptoms of childhood asthma and reducing the need for medication. Specifically, immunotherapy significantly reduced the total asthma symptom score (TASS, SMD=-1.05, 95% CI [-2.09; -0.01]) and total medication score (TMS, SMD=-1.32, 95%CI [-2.21; -0.43]). However, no significant difference was found in VAS score and FEV1% (SMD=-1.77, 95% CI [-3.76;0.22]; SMD = 0.51, 95% CI [-0.38;1.40]). All indicators had high heterogeneity.

CONCLUSION

Allergen-specific immunotherapy showed a positive effect in improving the symptoms of childhood asthma and reducing the need for medication, but there was significant heterogeneity among different studies. More high-quality RCTs are needed in the future to further explore the safety and long-term efficacy of immunotherapy to optimize its application in the management of childhood asthma.