A Meta-analysis Of Sublingual Immunotherapy In The Treatment Of Seasonal Allergic Rhinitis

Objective:To study the symptom scores,medication scores and adverse events of sublingual immunotherapy for seasonal rhinitis,and systematically evaluate the efficacy and adverse reactions of sublingual immunotherapy for patients with seasonal allergic rhinitis,and provide evidence-based reference for clinical treatment.Methods:Literature databases include Pub Med,Embase,Cochrane Library,Medline,CBM,Wanfang,CNKI,etc.The time of literature search was limited from 2007 to March of2018.The literature of randomized controlled trials of sublingual immunotherapy for seasonal allergic rhinitis was screened,and the quality of the included literature was evaluated,data was extracted,and meta-analysis was performed by using Rev Man5.3software.Results:A total of 13 studies were included in the analysis.Meta-analysis results:1.The sublingual immunotherapy group compared with the placebo group in the symptom scores of seasonal allergic rhinitis [SMD=-0.30,95% CI(-0.39,-0.22),P<0.00001];2.The sublingual immunotherapy group compared with the placebo group in the medication scores of seasonal allergic rhinitis [SMD=-0.18,95% CI(-0.29,-0.08),P=0.0005];3.The sublingual immunotherapy group compared with placebo group in the treatment of seasonal allergic rhinitis patients younger less than 18 years old in the symptom scores[SMD=-0.29,95% CI(-0.43,-0.15),P<0.0001],medication scores [SMD=-0.18,95%CI(-0.31,-0.04),P=0.009];4.The sublingual immunotherapy group compared with placebo group in the treatment of seasonal allergic rhinitis patients aged 18 years or older,in the symptom scores[SMD=-0.33,95% CI(-0.44,-0.22),P<0.00001 ],in the medication scores [SMD =-0.19,95% CI(-0.37,-0.02),P = 0.03];5.The sublingual immunotherapy group compared with placebo group in the treatment of seasonal allergic rhinitis for less than or equal to 6 months,in the symptom scores[SMD=-0.32,95% CI(-0.41,-0.23),P<0.00001],in the medication scores [SMD =-0.20,95% CI(-0.32,-0.08),P = 0.001];6.The sublingual immunotherapy group compared with the placebo group for seasonal allergic rhinitis for more than 6 months,in the symptom scores [SMD=-0.23,95% CI(-0.42,-0.03),P=0.02],in the medication scores [SMD=-0.14,95% CI(-0.35,-0.07),P=0.20];7.The sublingual immunotherapy group compared with the placebo group in the treatment of seasonal allergic rhinitis,in the incidence of adverse event [OR = 1.58,95%CI(1.32,1.89),P <0.00001].Conclusion:1.Sublingual immunotherapy group compared with placebo group for seasonal allergic rhinitis can reduce symptom scores and medication scores,which can alleviate the symptoms and reduce medication requirements in patients with seasonal allergic rhinitis;2.Sublingual immunotherapy for seasonal allergic rhinitis is not restricted by age in the relief of symptoms and there is no age restriction on reducing medication requirements;3.Regarding the time of sublingual immunotherapy,due to the small number of studies included,it can not be denied that prolonging the time of sublingual immunotherapy can improve the treatment effect;4.The incidence of adverse reactions was higher in the sublingual immunotherapy group than in the placebo group,but the adverse reactions were slightly controllable,and were mostly local,such as oral pruritus,ear pruritus,and throat irritation.