Efficacy and safety of allergen-specific immunotherapy for allergic asthma: a meta-analysis comparing sublingual and subcutaneous routes across allergen types and age groups.
Weimou Yin, Weitong Zeng, Yutong Li et al.
✦ AI-curated · Sources linked
In 30 seconds
This meta-analysis pooled 28 randomized controlled trials of allergen-specific immunotherapy (AIT) for allergic asthma, comparing subcutaneous (SCIT) and sublingual (SLIT) routes and examining age, treatment duration, and allergen type. AIT improved asthma symptoms and medication scores (both p < 0.001) and positively affected FEV1 (p < 0.001). SCIT showed greater efficacy for symptoms than SLIT. The analysis found no significant effect of age or treatment duration on outcomes, and AIT was effective for both house dust mite and grass pollen allergy. Total local side effects did not increase, whereas systemic reactions increased significantly.
Key findings
- Across 28 RCTs, AIT improved asthma symptoms (p < 0.001), with SCIT more efficacious than SLIT.
- AIT improved medication scores (p < 0.001) and positively affected FEV1 (p < 0.001).
- Age and treatment duration did not significantly affect outcomes; efficacy was reported for house dust mite and grass pollen allergy.
- AIT did not increase total local side effects but significantly increased systemic reactions.
Why it matters
The findings suggest AIT may improve asthma symptoms and reduce medication use in allergic asthma, while route and adverse-event profile are relevant when weighing treatment options. The reported increase in systemic reactions is important to balance against benefits. Because the analysis combines trials across allergens and patient groups, its subgroup findings can help frame—but do not settle—comparisons between routes or populations.
What to keep in mind
The abstract does not report pooled effect sizes or confidence intervals, limiting assessment of the magnitude and precision of benefits and harms.