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Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review

BACKGROUND: Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children. OBJECT: To evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite. METHOD: We searched the databases of Cochrane...

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Autores principales: Zheng, Chen, Xu, Hao, Huang, Shumin, Chen, Zhimin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310999/
https://www.ncbi.nlm.nih.gov/pubmed/37397157
http://dx.doi.org/10.3389/fped.2023.1137478
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author Zheng, Chen
Xu, Hao
Huang, Shumin
Chen, Zhimin
author_facet Zheng, Chen
Xu, Hao
Huang, Shumin
Chen, Zhimin
author_sort Zheng, Chen
collection PubMed
description BACKGROUND: Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children. OBJECT: To evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite. METHOD: We searched the databases of Cochrane Library, EMBASE and MEDLINE (from 1 January 1990 to 1 December 2022). Two reviewers independently screened studies, extracted data and critically appraised the risk of bias. We used the Revman 5 to synthesize the effect sizes. RESULTS: We finally selected 38 eligible studies including 21 randomized controlled trials to evaluate the efficacy and safety of SCIT and 17 observational studies to assess the safety. The results revealed that short-term asthma symptom scores were declined with a standardized mean difference (SMD) of −1.19 (95% CI: −1.87, −0.50) in 12 researches with high heterogeneity. Short-term asthma medication scores were decreased with SMD −1.04 (95% CI: −1.54, −0.54) in 12 heterogeneous researches. One study showed no significant reduction in combined symptom and medication scores without providing details. No studies we reviewed reported long-term efficacy. SCIT resulted in an obviously increased risk of adverse reactions compared with placebo. For secondary outcomes, SCIT improved life quality and reduced the numbers of annual asthma attacks and allergen-specific airway hyperreactivity, but without significant improvement in pulmonary function, asthma control or hospitalization. CONCLUSIONS: SCIT can reduce the short-term symptom scores and medication scores regardless of different treatment duration or mono/polysensitization, but with an increased incidence of local and systemic adverse effects. Further studies on pediatric asthma are needed to evaluate the long-term efficacy, and clarify the effectiveness of SCIT in specific population using mix allergen extracts or with severe asthma. Overall, it is recommended for children with mild-moderate HDM-driven allergic asthma.
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spelling pubmed-103109992023-07-01 Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review Zheng, Chen Xu, Hao Huang, Shumin Chen, Zhimin Front Pediatr Pediatrics BACKGROUND: Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children. OBJECT: To evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite. METHOD: We searched the databases of Cochrane Library, EMBASE and MEDLINE (from 1 January 1990 to 1 December 2022). Two reviewers independently screened studies, extracted data and critically appraised the risk of bias. We used the Revman 5 to synthesize the effect sizes. RESULTS: We finally selected 38 eligible studies including 21 randomized controlled trials to evaluate the efficacy and safety of SCIT and 17 observational studies to assess the safety. The results revealed that short-term asthma symptom scores were declined with a standardized mean difference (SMD) of −1.19 (95% CI: −1.87, −0.50) in 12 researches with high heterogeneity. Short-term asthma medication scores were decreased with SMD −1.04 (95% CI: −1.54, −0.54) in 12 heterogeneous researches. One study showed no significant reduction in combined symptom and medication scores without providing details. No studies we reviewed reported long-term efficacy. SCIT resulted in an obviously increased risk of adverse reactions compared with placebo. For secondary outcomes, SCIT improved life quality and reduced the numbers of annual asthma attacks and allergen-specific airway hyperreactivity, but without significant improvement in pulmonary function, asthma control or hospitalization. CONCLUSIONS: SCIT can reduce the short-term symptom scores and medication scores regardless of different treatment duration or mono/polysensitization, but with an increased incidence of local and systemic adverse effects. Further studies on pediatric asthma are needed to evaluate the long-term efficacy, and clarify the effectiveness of SCIT in specific population using mix allergen extracts or with severe asthma. Overall, it is recommended for children with mild-moderate HDM-driven allergic asthma. Frontiers Media S.A. 2023-06-15 /pmc/articles/PMC10310999/ /pubmed/37397157 http://dx.doi.org/10.3389/fped.2023.1137478 Text en © 2023 Zheng, Xu, Huang and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Zheng, Chen
Xu, Hao
Huang, Shumin
Chen, Zhimin
Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
title Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
title_full Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
title_fullStr Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
title_full_unstemmed Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
title_short Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
title_sort efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310999/
https://www.ncbi.nlm.nih.gov/pubmed/37397157
http://dx.doi.org/10.3389/fped.2023.1137478
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