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Evidence summaries

Allergen Injection Immunotherapy for Seasonal Allergic Rhinitis

Allergen immunotherapy is effective in reducing symptoms and medication use in seasonal allergic rhinitis and conjunctivitis. Adverse effects appear to be rare. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 51 studies with a total of 2871 subjects, each receiving on average 18 injections. Duration of immunotherapy varied from three days to three years. Symptom score data from 15 trials were suitable for meta-analysis and showed an overall reduction in the immunotherapy group (SMD -0.73; 95% CI -0.97 to -0.50, P < 0.00001; n=1063). Reduction was seen in nasal symptoms (SMD -1.59, 95% CI -2.28 to -0.89; 8 trials, n=633), ocular symptoms (SMD -1.80, 95% CI -3.28 to -0.31; 3 trials, n=345), and brochial symptoms (SMD -0.59, 95% CI -1.06 to -0.11; 5 trials, n=429). Medication score data from 13 trials showed an overall reduction in the immunotherapy group (SMD of -0.57 (95% CI -0.82 to -0.33, p<0.00001)). Clinical interpretation of the effect size is difficult. Adrenaline was given in 0.13% (19 of 14085 injections) of those on active treatment and in 0.01% (1 of 8278 injections) of the placebo group for treatment of adverse events. There were no fatalities.

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References

  • Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev 2007 Jan 24;(1):CD001936. [PubMed]

Primary/Secondary Keywords