Wang Zhuang, Wang Na, Liang Xue, Wei Lina, Song Yongfu, Li Dongze, Wang Yongji
College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun City, Jilin Province, China.
Department of Pediatrics, Jilin Academy of Traditional Chinese Medicine, Changchun City, Jilin Province, China.
Eur Arch Otorhinolaryngol. 2025 Sep 11. doi: 10.1007/s00405-025-09664-7.
Reappraisal of Systematic reviews/Meta analyses on Sublingual Immunotherapy for Allergic Rhinitis: Evidence for Clinical Practice and Decision-Making.
A comprehensive computerized search was conducted across PubMed, Embase, the Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM databases from their inception to June 8, 2025, to systematically identify Systematic reviews and Meta analyses on Sublingual Immunotherapy for allergic rhinitis. A citation overlap matrix was constructed to calculate the corrected covered area, assessing the degree of primary study overlap. The risk of bias, methodological quality, reporting quality, and certainty of evidence in the included Systematic reviews/Meta analyses were evaluated using ROBIS, AMSTAR-2, PRISMA 2020, and GRADE tools, respectively. Both quantitative and qualitative analyses were performed on the primary outcomes to derive a more comprehensive and in-depth understanding.
A total of 20 Systematic reviews/Meta analyses were included in this umbrella review. The corrected covered area of 6.391% derived from the citation matrix analysis indicated a modest degree of primary study overlap among the included literature. Risk of bias assessment demonstrated that all incorporated studies exhibited low bias risk. Methodological quality evaluation revealed 2 high-quality, 3 moderate-quality, 14 low-quality, and 1 extremely low-quality study. Reporting quality assessment yielded scores ranging from 22 to 41.5, with 7 studies classified as high-quality, 11 as moderate-quality, and 2 as low-quality reports. The evidence quality assessment revealed that among all evaluated outcomes, 7 were rated as high quality, 19 as moderate quality, 31 as low quality, and 14 as extremely low quality according to the GRADE framework.
Current evidence demonstrates that Sublingual Immunotherapy exhibits favorable efficacy in improving symptom scores and medication use for allergic rhinitis, with generally acceptable safety profiles despite mild adverse reactions in some cases. Future research should focus on large-scale, real-world studies with diverse outcome measures, investigating variations in regional populations, allergen types, dosage regimens, and treatment durations to further optimize clinical application protocols for Sublingual Immunotherapy.
变应性鼻炎舌下免疫治疗系统评价/荟萃分析的重新评估：临床实践与决策依据
对PubMed、Embase、Cochrane图书馆、Web of Science、中国知网（CNKI）、维普资讯（VIP）、万方数据和中国生物医学文献数据库（CBM）从建库至2025年6月8日进行全面的计算机检索，以系统识别变应性鼻炎舌下免疫治疗的系统评价和荟萃分析。构建引用重叠矩阵以计算校正覆盖面积，评估原始研究的重叠程度。分别使用ROBIS、AMSTAR-2、PRISMA 2020和GRADE工具评估纳入的系统评价/荟萃分析中的偏倚风险、方法学质量、报告质量和证据确定性。对主要结局进行定量和定性分析，以获得更全面和深入的理解。
本伞状评价共纳入20篇系统评价/荟萃分析。引用矩阵分析得出的校正覆盖面积为6.391%，表明纳入文献中原始研究的重叠程度适中。偏倚风险评估表明，所有纳入研究的偏倚风险均较低。方法学质量评价显示，有2项高质量研究、3项中等质量研究、14项低质量研究和1项极低质量研究。报告质量评估得分在22至41.5之间，7项研究为高质量报告，11项为中等质量报告，2项为低质量报告。证据质量评估显示，根据GRADE框架，在所有评估结局中，7项为高质量，19项为中等质量，31项为低质量，14项为极低质量。
当前证据表明，舌下免疫治疗在改善变应性鼻炎症状评分和药物使用方面具有良好疗效，尽管在某些情况下有轻微不良反应，但安全性总体可接受。未来研究应聚焦于具有多样化结局指标的大规模真实世界研究，调查不同地区人群、变应原类型、给药方案和治疗持续时间的差异，以进一步优化舌下免疫治疗的临床应用方案。
