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Wise et al.

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.D.3-1. Recent systematic reviews and selected RDBPCTs for the use of SCIT in allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Lin et al. 1618 2013 1a Systematic review Rhinoconjunctivitis and/or asthma, adults and children Efficacy, effectiveness, safety. Symptoms, medication use, QOL. Rhinitis or rhinoconjunctivitis: 1 Symptoms (n = 1734): Strength of evidence high for SCIT. 2 Medication use (n = 564): Strength of evidence moderate for SCIT. 3 QOL (n = 532): Strength of evidence high for SCIT. Meadows et al. 1617 2013 1a Systematic review SAR, adults and children. Clinical effectiveness, cost effectiveness. Symptoms, medication use, QOL. 1 Symptoms (n = 659 active, 525 placebo): SMD −0.65, p < 0.00001 favoring SCIT. 2 Medication use (n = 621 active, 483 placebo): SMD −0.55, p < 0.00001 favoring SCIT. 3 QOL (n = 955): SMD −0.53, p < 0.00001, a 0.74-unit reduction in RQLQ compared with placebo. Purkey et al. 1619 2013 1a Systematic review SAR and PAR, adults and children, level 1b evidence, single-extract AIT Symptoms, medication use, QOL Bozek et al. 1622 2016 1b RDBPCT SAR (n = 55), age 65-75 years; Maintenance dose 26.3 μ g Phl p 5 Combined symptom medication score Klimek et al. 1605 2014 1b RDBPCT SAR (n = 102), age 18-75 years; Maintenance dose 24 μ g Gp 1 plus Gp 5 Symptoms, medication use Reduction in symptoms: 34% ( p = 0.004). Reduction in medication use: 40% ( p = 0.004). Pfaar et al. 1594 2013 1b RDBPCT SAR (n = 269), age 12-70 years. Maintenance dose Betv 1 6.75 μ g and Phl p 5 15.75 μ g Symptom-medication score Pfaar et al. 1593 2012 1b RDBPCT SAR (n = 179), age 11-69 years. Maintenance dose 31.5 μ g Phl p 5

Symptom-medication score reduced for grass and birch pollen seasons: 1st year 21% (NS), 2nd year 19.4% ( p = 0.0385). Symptom-medication score Symptom-medication score reduced: 1st year 16% ( p < 0.01), 2nd year 37% ( p < 0.01). Rajakulasingam 1621 2012 1b RDBPCT SAR (n = 37), ages 22-54 years. Maintenance dose 25.2 μ g group 5 Symptom improvement from baseline year

Improvement from baseline year of ≥2/10 in symptoms: active 65%, placebo 35% ( p = 0.024).

Third-year combined symptom-medication score reduced 41% from baseline ( p = 0.004) and 37% vs placebo.

SCIT for SAR and PAR has Aggregate Grade of Evidence A. SCIT is recommended for SAR or PAR patients not responsive to medical therapy, whose symptoms significantly affect QOL.

LOE = level of evidence; NS = not significant; PAR = perennial allergic rhinitis; QOL = quality of life; RDBPCT = randomized double-blind placebo-controlled trial; RQLQ = Rhinoconjunctivitis Quality of Life Questionnaire; SAR = seasonal allergic rhinitis; SCIT = subcutaneous immunotherapy; SMD = standardized mean difference.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.