1) Several studies reviewed found that allergen immunotherapy (AIT) can improve symptoms, medication use, and quality of life for patients with allergic asthma and rhinoconjunctivitis. 2) Subcutaneous immunotherapy was more effective than sublingual immunotherapy at improving quality of life and decreasing allergen-specific airway hyperactivity for asthma. 3) The evidence suggests AIT may help prevent new allergen sensitizations, though more high-quality studies are still needed to better determine its efficacy in preventing new sensitizations.

1. WHAT YOU SOULD HAVE READ BUT ………………… 2018
Immunotherapy
Attilio Boner
University of Verona, Italy
attilio.boner@univr.it

2. Selection of allergens

3. sottocutanea

4. Allergen immunotherapy for allergic asthma:
A systematic review and meta-analysis
S. Dhami, Allergy 2017;72:1825–1848
• Short-term symptom scores were
reduced but there was evidence
suggestive of publication bias.
• Short-term medication scores
were reduced, again with evidence
of potential publication bias.
98 studies

5. Allergen immunotherapy for allergic asthma:
A systematic review and meta-analysis
S. Dhami, Allergy 2017;72:1825–1848
• Subcutaneous immunotherapy
(SCIT) improved quality of life
and decreased allergen-specific
airway hyperreactivity (AHR),
but this was not the case for
sublingual immunotherapy (SLIT).
• There were no consistent
effects on asthma control,
exacerbations, lung function,
and nonspecific AHR.
98 studies

6. Allergen immunotherapy for allergic rhinoconjunctivitis:
A systematic review and meta-analysis
S Dhami, Allergy 2017;72:1597–1631
• 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.
 160 studies.

7. Meta-analysis of double-blind RCTs comparing symptom scores
between Subcutaneous immunotherapy (SCIT) and placebo groups
P<0.0001
Allergen immunotherapy for allergic rhinoconjunctivitis:
A systematic review and meta-analysis
S Dhami, Allergy 2017;72:1597–1631

8. Meta-analysis of double-blind
RCTs
comparing symptom scores
between Sublingual
immunotherapy (SLIT) and
placebo groups
P<0.0001
Allergen immunotherapy for allergic rhinoconjunctivitis:
A systematic review and meta-analysis
S Dhami, Allergy 2017;72:1597–1631

9. Sottocutanea
Effetti collaterali

10. • Food allergy
desensitisation
• L’ho messe nella
food allergy

11. sublinguale

12. epicutanea

13. Veleno di imenotteri

14. Preventive effects

15. Efficacy of allergen immunotherapy in reducing the
likelihood of developing new allergen sensitizations:
a systematic review. D Di Bona, Allergy 2017;72:691-704
• Low evidence supports the
position that AIT prevents
the onset of new allergen
sensitizations, with 10 of
18 studies reporting a
reduction in the onset
of new sensitizations
in patients treated with
AIT vs placebo.
 Risk difference in the onset
of new allergen
sensitizations between
patients treated with AIT
and pharmacotherapy.
 18 studies (1049 children,
10 057 adults)

16. Efficacy of allergen immunotherapy in reducing the
likelihood of developing new allergen sensitizations:
a systematic review. D Di Bona, Allergy 2017;72:691-704
• Low evidence supports the
position that AIT prevents
the onset of new allergen
sensitizations, with 10 of
18 studies reporting a
reduction in the onset
of new sensitizations
in patients treated with
AIT vs placebo.
 Risk difference in the onset
of new allergen
sensitizations between
patients treated with AIT
and pharmacotherapy.
 18 studies (1049 children,
10 057 adults)
Small studies and
studies with a
shorter follow-up
showed the highest
benefit of AIT.

17. Efficacy of allergen immunotherapy in reducing the
likelihood of developing new allergen sensitizations:
a systematic review. D Di Bona, Allergy 2017;72:691-704
• Low evidence supports the
position that AIT prevents
the onset of new allergen
sensitizations, with 10 of
18 studies reporting a
reduction in the onset
of new sensitizations
in patients treated with
AIT vs placebo.
 Risk difference in the onset
of new allergen
sensitizations between
patients treated with AIT
and pharmacotherapy.
 18 studies (1049 children,
10 057 adults)
The overall evidence
provides a low-grade
level of the evidence
supporting the efficacy
of AIT in preventing the
onset of new allergen
sensitizations,
but high-quality studies
could change this
estimate.

18. Future possibilities