Objective: The primary objective of this systematic review is to evaluate the role of personalized immunotherapy against allergy in pediatric population affected with allergy in upper airways that include conditions like allergic rhinitis, asthma, rhino-conjunctivitis, etc. This can be determined through evaluating clinical efficacy and safety of sublingual immunotherapy (SLIT) in children affected with different types of allergens.
The secondary objective is to evaluate the reduction of symptomatic medication usage and evaluate long term use of SLIT.
Methods: A systematic literature review is conducted to determine the clinical efficacy and safety behind the basic concept of administration of increasing amounts of allergen(s) in sublingual route, to allergic subjects to achieve hypo sensitization and reduction of symptoms occurring during the natural exposure to the allergen(s) itself and to review the long term use of allergen administration. The search is focused on all the randomized clinical trials of sublingual immunotherapy in children (below 18 years) with upper airway diseases associated with allergy. Identification, screening and inclusions are done from PubMed, CINAHL and Cochrane library. The research includes all studies that used personalized approach of introducing external allergens in children through sublingual route in the year 1999 to 2014. Total 30 studies with 2939children with allergic rhinitis, asthma, rhino-conjunctivitis were involved in this systematic review. The outcomes of the selected studies were evaluated.
Result: The result is evaluated for the effectiveness of the SLIT on the basis of baseline comparison, reduction of symptoms score and medication score and improvement of visual analogue scale (VAS) and clinical improvement. For safety analysis parameters were chosen based on reported adverse events and their severity. The data from 19 studies (n=2126) provided efficacy and safety evaluable data, 8 studies (n=484) provided only effective data, and 2 studies provided only safety data (n=258) and 1 study (71) found which specially focused on patient compliance. The result from 6 studies is instrumental to determine the long term efficacy of the sublingual immunotherapy.
Conclusion: This systemic review concluded that SLIT is effective through significant reduction of symptom-medication score and also well tolerated therapy for children with upper airway diseases associated with allergy.
