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Cited by 105Allergic Rhinitis and SensitizationFood Allergy and Anaphylaxis ResearchAsthma and respiratory diseases

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Efficacy of Grass Pollen Allergen Sublingual Immunotherapy Tablets for Seasonal Allergic Rhinoconjunctivitis: A Systematic Review and Meta-analysis

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Di Bona, Danilo, Plaia, Antonella, Leto-Barone, Maria Stefania, La Piana, Simona, Di Lorenzo, Gabriele·2015·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2015.2840
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Abstract

IMPORTANCE: Randomized clinical trials (RCTs) and meta-analyses of sublingual immunotherapy (SLIT) for the treatment of seasonal allergic rhinoconjunctivitis (SARC) have shown a modest clinical benefit compared with placebo. Furthermore, indirect comparison by meta-analyses showed that subcutaneous immunotherapy is more effective than SLIT. Despite these data, SLIT has become the most prescribed treatment of SARC in Europe in recent years, and it was approved by the US Food and Drug Administration for the treatment of SARC to grass pollen in the United States on April 1, 2014. OBJECTIVE: To assess the efficacy and safety of the grass pollen sublingual tablets licensed as drugs in the treatment of patients with SARC to grass pollen. DATA SOURCES: Computerized bibliographic searches of MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov (from inception to April 30, 2014) were supplemented with a manual search of reference lists. STUDY SELECTION: Randomized clinical trials were included if they compared the grass pollen SLIT tablets approved by regulatory authorities in the European Union and the United States for SARC with placebo. DATA EXTRACTION AND SYNTHESIS: Data on populations, interventions, and outcomes were extracted from each RCT according to the intent-to-treat method by 2 independent observers and were combined using the method by DerSimonian and Laird. MAIN OUTCOMES AND MEASURES: The primary end point was the difference in the symptom score and medication score between SLIT and placebo. We pooled data using random-effects meta-analysis, with standardized mean differences (SMDs) and 95% CIs reported. RESULTS: Data were available in 13 RCTs for the symptom score (4659 patients) and in 12 RCTs for the medication score (4558 patients). We found a small treatment benefit in the symptom score (SMD, -0.28; 95% CI, -0.37 to -0.19; P < .001) and in the medication score (SMD, -0.24; 95% CI, -0.31 to -0.17; P < .001). Adverse events were reported in 1384 of 2259 patients (61.3%) receiving SLIT and in 477 of 2279 patients (20.9%) receiving placebo. Seven patients in the SLIT group reported treatment-related adverse events requiring epinephrine. CONCLUSIONS AND RELEVANCE: Findings show a small benefit of the grass pollen sublingual tablets in reducing symptoms and in decreasing the use of symptomatic medication (antihistamines and corticosteroids) in patients with SARC. Considering the low magnitude of the benefit, the convenience and easy administration do not seem to be sufficient reasons for the choice of SLIT.

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Metadata

Authors
Di Bona, D., Plaia, A., Leto-Barone, M. S., La Piana, S., & Di Lorenzo, G.
Affiliations
  • Unità Operativa di Immunoematologia e Medicina Trasfusionale, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy
  • University of Palermo (IT)
  • Dipartimento BioMedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
ORCID
Plaia, Antonella
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2015-08-01
Volume
175
Issue
8
Pages
1301
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2015.2840
OpenAlex
W1875082978
Cited by
105
References
2
Citations by year
2026: 8 · 2025: 4 · 2024: 5 · 2023: 8 · 2022: 4 · 2021: 2 · 2020: 10 · 2019: 10 · 2018: 8 · 2017: 15 · 2016: 24 · 2015: 7
FWCI
15.87
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
  • CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
Topics
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
  • Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Keywords
sublingual immunotherapy, grass pollen allergy, seasonal allergic rhinoconjunctivitis, symptom scores, medication score, adverse events, subcutaneous immunotherapy, treatment efficacy, drug safety, regulatory approval, placebo comparison, standardized mean difference, confidence interval width, confidence interval coverage
MeSH terms
Allergens, Conjunctivitis, Allergic, Rhinitis, Allergic, Seasonal, Humans, Plant Extracts, Antigens, Plant, Sublingual Immunotherapy

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CoChat. (2026). Citation check: Efficacy of Grass Pollen Allergen Sublingual Immunotherapy Tablets for Seasonal Allergic Rhinoconjunctivitis: A Systematic Review and Meta-analysis. https://app.cochat.ai/papers/10.1001/jamainternmed.2015.2840
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Di Bona, D., Plaia, A., Leto-Barone, M. S., La Piana, S., & Di Lorenzo, G. (2015). Efficacy of Grass Pollen Allergen Sublingual Immunotherapy Tablets for Seasonal Allergic Rhinoconjunctivitis: A Systematic Review and Meta-analysis. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2015.2840