A Cochrane review [Abstract] 1 included 60 RCTs in the review. Forty-nine RCTs were suitable for pooling in meta-analyses (2333 patients with sublingual immunotherapy, 2256 patients with placebo). Immunotherapy involved the administration of gradually increasing doses of the allergen over a period of time to desensitise the patient. Overall, there was a significant reduction in symptoms (SMD -0.49; 95% CI -0.64 to -0.34, P < 0.00001) and medication requirements (SMD -0.32; 95% CI -0.43 to -0.21, P < 0.00001) in participants receiving sublingual immunotherapy compared to placebo. None of the trials included in this review reported severe systemic reactions or anaphylaxis, and none of the systemic reactions reported required the use of adrenaline.
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