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Wise et al.

Page 420

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.D.4-2. cost

Recommendation,

considering: harm and

evidence Direction of impact Magnitude of impact a SLIT is effective for AR symptom reduction in adults A Yes Low impact Strong recommendation LOE: Lin 1a; Radulovic 1a; Di Bona (2 studies) 1a; Nelson 1b; Calderon 2a. SLIT is effective for AR symptom reduction in children B Yes Low impact Recommendation LOE: Kim 2a; Larenas-Linnemann 2a. Not enough evidence: Roder 2a. SLIT is safe for the treatment of AR in adults A Yes —— Safety profile is very good

Many of the systematic reviews (1a and 2a) included safety evaluation. Makatsori 1a: same dropout rates SLIT vs placebo. SLIT is safe for the treatment of AR in children B Yes —— Safety profile is very good The systematic reviews (Kim, Larenas-Linnemann, Roder: all 2a) included safety evaluation. Makatsori 1a: same dropout rates SLIT vs placebo. SCIT is more effective than SLIT A Yes Weak evidence Recommendation LOE: Chelladurai 1a; Dretzke 2a; Calderon 2a; Kim 2a. Grass pollen tablets/drops vs SCIT: Di Bona 2012 1a; SCIT = grass pollen tablets only, drops slightly less effective Nelson 1b. SLIT is safer than SCIT B Yes Weak evidence Recommendation LOE: Aasbjerg 2a The total cost of SLIT is less than SCIT A Yes Moderate evidence Recommendation LOE: Meadows 1a (UK setting); Dranitsaris 2a (Canadian setting) It is safe to continue SLIT during pregnancy B No added risk. Moderate evidence Recommendation LOE: Oykman 3a It is safe to start SLIT during the season B Slightly added risk. Moderate evidence Option LOE: Creticos 2a Tablet SLIT is more effective than pharmacotherapy. Exception in SAR: INCS are as efficacious as tablet SLIT. A Yes Moderate: antihistamine, montelukast. Weak: INCS Recommendation LOE: Devillier 1a (pollen tablet SLIT); Durham 1b (grass pollen or ragweed tablet SLIT). SLIT is cost-effective in the 1st year B No Moderate evidence Option (considering its long-term benefit) LOE: Meadows 1a; Dranitsaris 2a SLIT is cost-effective after several years of treatment B Yes Weak-moderate Recommendation LOE: Meadows 1a; Dranitsaris 2a

Aggregate grade of

Aggregate grades of evidence for specific SLIT issues Issue

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