Subcutaneous, sublingual immunotherapy to aeroallergens helps with atopic dermatitis

The use of sublingual (SLIT) or subcutaneous (SCIT) immunotherapy against aeroallergens can help improve disease severity and quality of life (QoL) among patients with atopic dermatitis (AD), reports a recent meta-analysis.

The quantitative synthesis included 23 randomized controlled trials, totaling 1,957 adults and children with AD. Only studies that compared SLIT or SCIT against no allergen immunotherapy (AIT) were eligible for enrollment. Databases accessed included Medline, Embase, Web of Science, GREAT, CINAHL, LILACs, and CENTRAL.

Immunotherapy methods were assessed according to set of patient-important outcomes, including AD severity, QoL, itch, flares, and adverse events.

Pooled analysis revealed that SCIT and SLIT were both similarly effective as compared with control and were >50 percent more likely to result in meaningful AD improvements, defined as a ≥50-percent reduction in the SCORing AD scale (relative risk [RR], 1.53, 95 percent confidence interval [CI], 1.31–1.78).

Similarly, patients treated with SCIT or SLIT were significantly more likely to see at least a 4-point improvement in the Dermatology Life Quality Index (RR, 1.44, 95 percent CI, 1.03–2.01).

Both AITs were also associated with a higher risk of adverse events (RR, 1.61, 95 percent CI, 1.44–1.79) as opposed to controls.

“This synthesis of current best evidence shows that aeroallergen AIT improves AD outcomes in patient-important ways that is balanced by a modest increase in harms,” the researchers said, adding that toxicities may be more important for SCIT than they are for SLIT.