@article{3001231,
    title = "Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis",
    author = "Dhami, S. and Nurmatov, U. and Arasi, S. and Khan, T. and Asaria, M. and Zaman, H. and Agarwal, A. and Netuveli, G. and Roberts, G. and Pfaar, O. and Muraro, A. and Ansotegui, I.J. and Calderon, M. and Cingi, C. and Durham, S. and van Wijk, R.G. and Halken, S. and Hamelmann, E. and Hellings, P. and Jacobsen, L. and Knol, E. and Larenas-Linnemann, D. and Lin, S. and Maggina, P. and Mösges, R. and Oude Elberink, H. and Pajno, G. and Panwankar, R. and Pastorello, E. and Penagos, M. and Pitsios, C. and Rotiroti, G. and Timmermans, F. and Tsilochristou, O. and Varga, E.-M. and Schmidt-Weber, C. and Wilkinson, J. and Williams, A. and Worm, M. and Zhang, L. and Sheikh, A.",
    journal = "Allergy: European Journal of Allergy and Clinical Immunology",
    year = "2017",
    volume = "72",
    number = "11",
    pages = "1597-1631",
    publisher = "Wiley-Blackwell Publishing Ltd",
    doi = "10.1111/all.13201",
    keywords = "allergen;  allergen, clinical outcome;  cost effectiveness analysis;  Dermatophagoides;  desensitization;  grass pollen;  human;  intralymphatic immunotherapy;  patient safety;  pollen;  pollen allergy;  priority journal;  quality of life;  Review;  scoring system;  sensitivity analysis;  subcutaneous immunotherapy;  sublingual immunotherapy;  systematic review;  therapy effect;  tree;  weed;  allergic conjunctivitis;  desensitization;  factual database;  immunology;  meta analysis;  pollen allergy;  procedures, Allergens;  Conjunctivitis, Allergic;  Databases, Factual;  Desensitization, Immunologic;  Humans;  Rhinitis, Allergic, Seasonal",
    abstract = "Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis. Methods: We searched nine international biomedical databases for published, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses. Results: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD −0.53, 95% CI −0.63, −0.42), medication (SMD −0.37, 95% CI −0.49, −0.26), and combined symptom and medication (SMD −0.49, 95% CI −0.69, −0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores. Conclusions: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd."
}