Efficacy of sublingual immunotherapy in asthma: systematic review of randomized-clinical trials using the Cochrane Collaboration method.
BACKGROUND
Sublingual immunotherapy (SLIT) is effective and safe in the treatment of allergic rhinitis. However, there is no meta-analysis in asthma treatment.


METHODS
The clinical efficacy of SLIT for asthma was evaluated through a systematic review with meta-analysis. MEDLINE (1966-2005), EMBASE (1974-2005), LILACS (1982-2005), and the Cochrane Library were searched for related literature in any language. Randomized-controlled clinical trials (RCT) on SLIT in asthma treatment for adults and children were selected. From 119 citations, 25 studies with 1706 patients were included in this meta-analysis. For each report, quality scores were assigned and data were extracted in relation to the outcomes analyzed: asthmatic symptoms, use of asthma medications, lung function, and bronchial provocation.


RESULTS
According to the Jadad quality method, 64% of the studies were assigned scores of 4 or 5. Immunotherapy was seen to significantly reduce asthma severity when parameter compositions were all analyzed by categorical outcomes. There was a nonsignificant reduction in asthma symptoms when analyzed using standardized mean differences. No severe reactions were observed.


CONCLUSIONS
This meta-analysis found that SLIT is beneficial for asthma treatment albeit the magnitude of the effect is not very large. Moreover, it is a safe alternative to the subcutaneous route. More RCT with standardization of symptom scores and medications are needed in order to contribute further to this subject.
Calamita
Z
Z
Division of Internal Medicine and Allergy and Immunology, Medical School of Marília, Marília, São Paulo, Brazil.
Saconato
H
H
Pelá
A B
AB
Atallah
A N
AN
D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D002648:Child; D003627:Data Interpretation, Statistical; D003888:Desensitization, Immunologic / Q000009:adverse effects; D006801:Humans; D007167:Immunotherapy; D016032:Randomized Controlled Trials as Topic