Immunotherapy: The Meta-Analyses. What have we Learned?

Immunology and Allergy Clinics of North America

Volumn 31, Issue 2, 2011, Pages 159-173

  Calderón, Moisés A ^a   Boyle, Robert J ^b   Penagos, Martin ^c   Sheikh, Aziz ^d  

^a ROYAL BROMPTON AND HAREFIELD NHS FOUNDATION TRUST   (United Kingdom)

^b ST MARY S HOSPITAL   (United Kingdom)

^c ST THOMAS HOSPITAL   (United Kingdom)

^d UNIVERSITY OF EDINBURGH   (United Kingdom)

Author keywords

Asthma; Meta analysis; Rhinitis; Specific allergen immunotherapy

Indexed keywords

ALLERGEN; ANTIASTHMATIC AGENT; GRASS POLLEN EXTRACT; HOUSE DUST ALLERGEN; PLACEBO; POLLEN ANTIGEN; RAGWEED ANTIGEN;

ADULT; AGED; ALLERGEN SPECIFIC IMMUNOTHERAPY; ALLERGIC ASTHMA; ALLERGIC REACTION; ASTHMATIC STATE; CHILD; CONTROLLED STUDY; DRUG EFFICACY; DRUG SAFETY; DRUG TARGETING; DRUG USE; GRASS POLLEN; HAY FEVER; HOUSE DUST ALLERGY; HUMAN; IMMUNOTHERAPY; MAJOR CLINICAL STUDY; META ANALYSIS; OUTCOME ASSESSMENT; PERENNIAL RHINITIS; POLLEN ALLERGY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; REVIEW; SYSTEMATIC REVIEW; TREATMENT DURATION;

ADMINISTRATION, CUTANEOUS; ADMINISTRATION, SUBLINGUAL; ALLERGENS; DESENSITIZATION, IMMUNOLOGIC; HUMANS; HYPERSENSITIVITY; TREATMENT OUTCOME;

EID: 79955416077     PISSN: 08898561     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.iac.2011.02.002     Document Type: Review

References (47)

1. Noon L. Prophylactic inoculation against hay fever. Lancet 1911, i:1572.
2. Bousquet J., Lockey R., Malling H.J. Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol 1998, 102(4 Pt 1):558-562.
3. International Consensus Report on diagnosis and management of asthma. International Asthma Management Project. Allergy 1992, 47:S1-S61.
4. Bousquet J., Van Cauwenberge P., Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001, 108:S147-S334.
5. Cox L., Li J.T., Nelson H., et al. Allergen immunotherapy: a practice parameter second update. J Allergy Clin Immunol 2007, 120:S25-S85.
6. Bateman E.D., Hurd S.S., Barnes P.J., et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008, 31(1):143-178.
7. Passalacqua G., Compalati E., Canonica G.W. Advances in allergen-specific immunotherapy. Curr Drug Targets 2009, 10(12):1255-1262.
8. Canonica G.W., Bousquet J., Casale T., et al. Sub-lingual immunotherapy: world allergy organization position paper 2009. Allergy 2009, 64(Suppl 91):1-59.
9. Calderon M.A. Meta-analyses of specific immunotherapy trials. Drugs Today (Barc) 2008, 44:S31-S34.
10. Compalati E., Penagos M., Tarantini F., et al. Specific immunotherapy for respiratory allergy: state of the art according to current meta-analyses. Ann Allergy Asthma Immunol 2009, 102:22-28.
11. Calderon M.A., Boyle R., Nankervis H., et al. Specific allergen immunotherapy for the treatment of atopic eczema (Protocol). Cochrane Database Syst Rev 2010, 10. CD008774.
12. Compalati E., Massimo L., Anthi R., et al. Meta-analysis of immunotherapy for atopic dermatitis. Allergy 2010, 65:S92.
13. Watanabe A.S., Fonseca L.A., Galvão C.E., et al. Specific immunotherapy using Hymenoptera venom: systematic review. Sao Paulo Med J 2010, 128(1):30-37.
14. Ross R.N., Nelson H.S., Finegold I. Effectiveness of specific immunotherapy in the treatment of hymenoptera venom hypersensitivity: a meta-analysis. Clin Ther 2000, 22(3):351-358.
15. Elremeli M., Bulsara M.K., Daniels M., et al. Venom immunotherapy for preventing allergic reactions to insect stings (Protocol). Cochrane Database Syst Rev 2010, 11. CD008838.
16. Lin D., Li W.K., Rieder M.J. Cotrimoxazole for prophylaxis or treatment of opportunistic infections of HIV/AIDS in patients with previous history of hypersensitivity to cotrimoxazole. Cochrane Database Syst Rev 2007, 2. CD005646.
17. Fisher H.R., Toit G., Lack G. Specific oral tolerance induction in food allergic children: is oral desensitisation more effective than allergen avoidance? a meta-analysis of published RCTs. Arch Dis Child 2011, 96(3):259-264.
18. Cochrane handbook for systematic reviews of interventions, version 5.1.0 [updated March 2011] 2011, The Cochrane Collaboration, Available at:, Accessed February 26, 2011. http://www.cochrane-handbook.org, J.P.T. Higgins, S. Green (Eds.).
19. Perera R., Heneghan C. Interpreting meta-analyses in systematic reviews. Ann Intern Med 2009, 150:JC2-2. JC2-3.
20. Leucht S., Kissling W., Davis J.M. How to read and understand and use systematic reviews and meta-analyses. Acta Psychiatr Scand 2009, 119:443-450.
21. Cohen J. Statistical power analysis for the behavioral sciences 1988, Lawrence Erlbaum Associates, Hillsdale (NJ). 2nd edition.
22. Egger M., Smith G.D., Phillips A.N. Meta-analysis: principles and procedures. BMJ 1997, 315:1533-1537.
23. Klimek L., Malling H.J. HNO 1999, 47(7):602-610. [in German].
24. Ross R.N., Nelson H.S., Finegold I. Effectiveness of specific immunotherapy in the treatment of allergic rhinitis: an analysis of randomized, prospective, single- or double-blind, placebo-controlled studies. Clin Ther 2000, 22(3):342-350.
25. Calderon M.A., Alves B., Jacobson M., et al. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev 2007, 1. CD001936.
26. Wilson D.R., Lima M.T., Durham S.T. Sublingual immunotherapy for allergic rhinitis: systematic review and meta-analysis. Allergy 2005, 60:4-12.
27. Radulovic S., Calderon M.A., Wilson D., et al. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010, 12. CD002893.
28. Penagos M., Compalati E., Tarantini F., et al. Efficacy of sublingual immunotherapy in the treatment of allergic rhinitis in pediatric patients 3 to 18 years of age: a meta-analysis of randomized, placebo-controlled, double-blind trials. Ann Allergy Asthma Immunol 2006, 97:141-148.
29. Olaguíbel J.M., Alvarez Puebla M.J. Efficacy of sublingual allergen vaccination for respiratory allergy in children. Conclusions from one meta-analysis. J Investig Allergol Clin Immunol 2005, 15:9-16.
30. Compalati E., Passalacqua G., Bonini M., et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy 2009, 64:1570-1579.
31. Di Bona D., Plaia A., Scafidi V., et al. Efficacy of sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: a systematic review and meta-analysis. J Allergy Clin Immunol 2010, 126(3):558-566.
32. Abramson M.J., Puy R.M., Weiner J.M. Is allergen immunotherapy effective in asthma? A meta-analysis of randomized controlled trials. Am J Respir Crit Care Med 1995, 151(4):969-974.
33. Abramson M.J., Puy R.M., Weiner J.M. Allergen immunotherapy for asthma. Cochrane Database Syst Rev 2003, 4. CD001186.
34. Abramson M.J., Puy R.M., Weiner J.M. Injection allergen immunotherapy for asthma. Cochrane Database Syst Rev 2010, 8. CD001186.
35. Ross R.N., Nelson H.S., Finegold I. Effectiveness of specific immunotherapy in the treatment of asthma: a meta-analysis of prospective, randomized, double-blind, placebo-controlled studies. Clin Ther 2000, 22(3):329-341.
36. Calamita Z., Saconato H., Pela A.B., et al. Efficacy of sublingual immunotherapy in asthma: systematic review of randomized-clinical trials using the Cochrane Collaboration method. Allergy 2006, 61:1162-1172.
37. Penagos M., Passalaqua G., Compalati E., et al. Metaanalysis of the efficacy of sublingual immunotherapy in the treatment of allergic asthma in pediatric patients, 3 to 18 years of age. Chest 2008, 133:599-609.
38. Calderon M., Strodl Andersen J., Lawton S. Meta-analysis supports the efficacy of grass allergy immunotherapy tablets is comparable to subcutaneous immunotherapy Available at:, Accessed February 26, 2011. http://eaaci.net/images/files/Abstract_Books/2010/Abstract_Book_ERAM-SERIN2010.pdf.
39. Calderón M.A., Casale T.B., Togias A., et al. Allergen-specific immunotherapy for respiratory allergies: from meta-analysis to registration and beyond. J Allergy Clin Immunol 2011, 127(1):30-38.
40. Cox L., Larenas-Linnemann D., Lockey R., et al. Speaking the same language: the world allergy organization subcutaneous immunotherapy systemic reaction grading system. J Allergy Clin Immunol 2010, 125(3):569-574.
41. Shea B.J., Hamel C., Wells G.A., et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol 2009, 62(10):1013-1020.
42. Kung J., Chiappelli F., Cajulis O.O., et al. From systematic reviews to clinical recommendations for evidence-based health care: validation of Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) for grading of clinical relevance. Open Dent J 2010, 16(4):84-91.
43. Brożek J.L., Akl E.A., Compalati E., GRADE Working Group, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines Part 3 of 3. The GRADE approach to developing recommendations. Allergy 2011, DOI: 10.1111/j.1398-9995.2010.02530.x. [Epub ahead of print].
44. Moher D., Liberati A., Tetzlaff J., PRISMA Group, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Ann Intern Med 2009, 151:264-269.
45. Casale T.B., Canonica G.W., Bousquet J., et al. Recommendations for appropriate sublingual immunotherapy clinical trials. J Allergy Clin Immunol 2009, 124:665-670.
46. Nieto A., Mazon A., Pamies R., et al. Sublingual immunotherapy for allergic respiratory diseases: an evaluation of meta-analyses. J Allergy Clin Immunol 2009, 124:157-161.
47. Bousquet P.J., Calderón M.A., Demoly P., et al. The Consolidated Standards of Reporting Trials (CONSORT) Statement applied to allergen-specific immunotherapy with inhalant allergens: a Global Allergy and Asthma European Network (GA(2)LEN) article. J Allergy Clin Immunol 2011, 127(1):49-56.