title: Efficacy of allergen-specific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Allergen-specific immunotherapy (allergen-SIT) is the only treatment directed at the cause of IgE-mediated allergic diseases. However, there is controversy over the use of SIT for patients with atopic dermatitis.
  
  
  OBJECTIVE
  We performed a systematic review and meta-analysis to assess the efficacy of SIT for patients with atopic dermatitis.
  
  
  METHODS
  We performed manual searches of reference lists and computerized searches of the MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane databases (through December 10, 2012) for randomized controlled trials that compared SIT with placebo for patients with atopic dermatitis. The outcome of interest was a dichotomous variable, in terms of treatment success; a meta-analysis was performed by using a random-effects analysis. Subgroup analyses were carried out to evaluate the effects of long-term treatment (more than 1 year), SIT for severe atopic dermatitis, SIT for children, and subcutaneous and sublingual administration of immunotherapy.
  
  
  RESULTS
  We analyzed 8 randomized controlled trials that comprised a total of 385 subjects. We found that SIT has a significant positive effect on atopic dermatitis (odds ratio [OR], 5.35; 95% CI, 1.61-17.77; number needed to treat, 3; 95% CI, 2-9). SIT also showed significant efficacy in long-term treatment (OR, 6.42; 95% CI, 1.50-27.52) for patients with severe atopic dermatitis (OR, 3.13; 95% CI, 1.31-7.48), and when administered subcutaneously (OR, 4.27; 95% CI, 1.36-13.39).
  
  
  CONCLUSIONS
  A meta-analysis provides moderate-level evidence for the efficacy of SIT against atopic dermatitis. However, these findings are based on an analysis of a small number of randomized controlled trials, with considerable heterogeneity among trials.
authors: Department of Dermatology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors: Jung Min
authors: JM
authors: Bae
authors: Yoon Young
authors: YY
authors: Choi
authors: Chang Ook
authors: CO
authors: Park
authors: Kee Yang
authors: KY
authors: Chung
authors: Kwang Hoon
authors: KH
authors: Lee
mesh_terms: D015982:Bias; D003876:Dermatitis, Atopic / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000009:adverse effects; D006801:Humans; D016032:Randomized Controlled Trials as Topic