Allergy immunotherapies for allergic rhinitis: systematic review and assessment of evolving qualityA. Domdey1,3, A. Njue email@example.com, W. Nuabor2, M. Lyall2, A. Heyes2, L. Elliott1Show more: Authors information and Publication history
1ALK-Abellˇ, H°rsholm, Denmark
2RTI Health Solutions, Manchester, United Kingdom
3Current affiliation, Lundbeck A/S, Copenhagen, Denmark
Published online: 12 June 2019
Accepted: 30 April 2019
Received: 11 April 2019
Heterogeneity in the design and quality of trials evaluating allergy immunotherapies (AITs) limits their comparability, making it difficult for physicians, patients, and payers to select the best treatment option. Methods.
This systematic review evaluated the quality of randomised controlled trials (RCTs) of registered grass AITs using the National Institute of Health and Care Excellence checklist. Results.
17 of 44 unique RCTs (38.6%) (sample size range: 18-1,501 subjects) were subcutaneous grass immunotherapy trials and 27 (61.4%) were sublingual grass immunotherapy trials (Allergovit, 5 trials; Alutard, 8; Grazax, 13; Oralair, 6; Staloral, 8; Pollinex, 2; Phostal and Purethal, 1 each). Three trials (6.8%; all Grazax) fulfilled every quality criterion. Quality assessments revealed inconsistencies in study quality and reporting. Study quality trended towards improvement over time, particularly after 2009. Conclusions.
When assessing grass AIT, it is important to focus not only on endpoints but also on the quality of evidence. Key words
allergic asthma; allergic rhinitis; allergy immunotherapy; grass allergy; quality assessment