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For house dust mite allergy, sublingual immunotherapy or subcutaneous immunotherapy?

Published: August 28, 2021

Subcutaneous and sublingual allergen immunotherapies (SCIT and SLIT, respectively) are effective therapeutic approaches for treating house dust mite (HDM) allergy, but studies analyzing clinical efficacy between these modalities are limited.

Kim et al. performed a meta-analysis of existing studies to compare the efficacy of SLIT drop, SLIT tablet, and SCIT in patients with perennial allergic rhinitis utilizing a network meta-analysis (J Allergy Clin Immunol Pract 2021;9:4450-8). Twenty-six and 18 double-blind randomized clinical trials were included in this meta-analysis for symptom score and medication score, respectively.

In direct pairwise meta-analysis, a significant reduction of symptom score was observed for all immunotherapy modalities as compared to placebo. In addition, a significant reduction of medication score was observed for all modalities. In network meta-analysis, the clinical efficacy of SCIT based on symptom score was greater than that of SLIT drop or SLIT tablet. However, there was no significant difference in the symptom score between SLIT drop and SLIT tablet. This study demonstrated clinical efficacy of all HDM immunotherapy modalities and suggested that SCIT may be more effective than SLIT drops or tablets in controlling symptoms of allergic rhinitis.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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