The efficacy and safety of subcutaneous immunotherapy in mite-sensitized subjects with asthma: a meta-analysis.

Abstract

Subcutaneous immunotherapy (SCIT) is widely used in the management of allergic diseases such as allergic asthma. We aimed to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of SCIT in mite-sensitized subjects with asthma. Literature from January 1990 to February 2013 on the efficacy and safety of SCIT for mite-sensitized asthma patients was searched in electronic databases, including the Cochrane Library, MEDLINE, Embase, PubMed, China Knowledge Resource Integrated Database, Wanfang, and Vendor Information Pages. Data were extracted from randomized controlled trials (RCTs) according to the selection criteria by 2 investigators independently. The quality of included trials was evaluated according to the Jadad scale standard. A total of 796 subjects from 19 different RCTs were included in this analysis. SCIT significantly reduced the asthma symptom scores (standardized mean difference of -0.94, 95% CI -1.58 to -0.29, P=.004) and the asthma medication scores (standardized mean difference of -1.06, 95% CI -1.70 to -0.42, P=.001) compared with the control group. However, there were no significant differences between subjects receiving SCIT and the control group in lung function (peak expiratory flow, percent-of-predicted FEV1, percent-of-predicted FVC) and specific antibody (allergen-specific immunoglobulin E) levels of blood serum (P>.05). In the studies containing data on safety, the incidences of systemic and local adverse reactions were 9.1% (8/88) and 17.2% (23/134), respectively, in subjects treated with SCIT, and no severe adverse events were reported. Our results suggest that SCIT is helpful in alleviating symptoms and reducing medication used in mite-sensitive asthma subjects, but with no improvement in lung function. The safety of SCIT is acceptable.