본문 바로가기
KERD
논문KCI 등재

통년성 알레르기 비염에서 피하 및 설하 면역 요법의 일대일 비교: 체계적인 고찰 및 메타 분석

Head-to-head comparison between subcutaneous and sublingual immunotherapy in perennial allergic rhinitis: A systematic review and meta-analysis

최정희|심진아|김효빈|박도양|정수지
대한 소아알레르기 호흡기학회 (The Korean Academy Of Pediatric Allergy And Respiratory Disease)|2024.01|Allergy Asthma & Respiratory Disease (알레르기 천식 호흡기질환)|제12권 제1호|pp. 17-25|DOI https://doi.org/10.4168/aard.2024.12.1.17

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

.Allergic rhinitisMeta-analysisAllergensImmunotherapyHouse dust mites
주제분류소아과학

초록

.

Abstract

Purpose: Few meta-analyses of head-to-head comparisons between subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) for perennial allergic rhinitis (AR) have been performed so far. This study aimed to compare the efficacy, safety, and adherence of SCIT and SLIT in patients with house dust mite (HDM)-sensitized AR through a meta-analysis of head-to-head comparative studies. Methods: A meta-analysis based on direct comparisons of SCIT and SLIT in HDM-sensitized AR was performed, using randomized controlled trials (RCTs) and nonrandomized studies (NRSs), on efficacy, safety, and adherence, which had been published until April 30, 2021. Treatment efficacy was calculated as the standardized mean difference in symptoms and medication scores after treatment between SCIT and SLIT. Safety and adherence to treatment were compared with the relative risk (RR) of SCIT and SLIT. Results: Six RCTs and 3 NRS scores were analyzed. No statistically significant difference was noticed in improvement in symptoms and medication scores between SCIT and SLIT groups. Systemic adverse events occurred more frequently in SCIT than in SLIT in both RCT (RR, 3.97; 95% confidence interval [CI], 0.50–31.57) and NRS (RR, 5.48; 95% CI, 1.94–15.50). SCIT showed significantly higher adherence than did SLIT (RR, 1.16; 95% CI, 0.92–1.47). Conclusion: No significant difference in efficacy was noticed between the 2 modalities for HDM-sensitized AR. However, SLIT had significantly lower number of systemic adverse reactions, and SCIT had more preferable adherence.

참고문헌 (32)

  1. Skoner DP, "Allergic rhinitis : definition, epidemiology, pathophysiology, detection, and diagnosis", J Allergy Clin Immunol, 108(1 Suppl), pp.S2~S8 (2001)
  2. Dierick BJH, "Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy", Expert Rev Pharmacoecon Outcomes Res, 20, pp.437~453 (2020)
  3. Georgy MS, "Chapter 3 : allergen immunotherapy : definition, indication, and reactions", Allergy Asthma Proc, 33(Suppl 1), pp.9~11 (2012)
  4. Petalas K, "Allergen immunotherapy for allergic rhinitis", Rhinology, 51, pp.99~110 (2013)
  5. Calderon MA, "Allergen injection immunotherapy for perennial allergic rhinitis", Cochrane Database Syst Rev, 2019, pp.CD007163~ (2019)
  6. Huang Y, "Efficacy and safety of subcutaneous immunotherapy with house dust mite for allergic rhinitis : a meta-analysis of randomized controlled trials", Allergy, 74, pp.189~192 (2019)
  7. Canonica GW, "Sublingual immunotherapy : World Allergy Organization position paper 2013 update", World Allergy Organ J, 7, pp.6~ (2014)
  8. Yukselen A, "Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma : a randomized, placebo-controlled, double-blind, double-dummy study", Int Arch Allergy Immunol, 157, pp.288~298 (2012)
  9. Xian M, "Changes in CD4+CD25+FoxP3+ regulatory T cells and serum cytokines in sublingual and subcutaneous immunotherapy in allergic rhinitis with or without asthma", Int Arch Allergy Immunol, 181, pp.71~80 (2020)
  10. Khinchi MS, "Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy : a randomized, placebo-controlled, double-blind, double-dummy study", Allergy, 59, pp.45~53 (2004)
  11. Quirino T, "Sublingual versus injective immunotherapy in grass pollen allergic patients : a double blind(double dummy)study", Clin Exp Allergy, 26, pp.1253~1261 (1996)
  12. Ventura MT, "Clinical data and inflammation parameters in patients with cypress allergy treated with sublingual swallow therapy and subcutaneous immunotherapy", Int J Immunopathol Pharmacol, 22, pp.403~413 (2009)
  13. Di Bona D, "Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis : a meta-analysis-based comparison", J Allergy Clin Immunol, 130, pp.1097~1107 (2012)
  14. Kim JY, "Efficacy of subcutaneous and sublingual immunotherapy for house dust mite allergy : a network meta-analysis-based comparison", J Allergy Clin Immunol Pract, 9, pp.4450~4458 (2021)
  15. Tie K, "Subcutaneous versus sublingual immunotherapy for adults with allergic rhinitis : a systematic review with meta-analyses", Laryngoscope, 132, pp.499~508 (2022)
  16. Nelson H, "Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy", J Allergy Clin Immunol Pract, 3, pp.256~266 (2015)
  17. Incorvaia C, "Adherence to sublingual immunotherapy", Curr Allergy Asthma Rep, 16, pp.12~ (2016)
  18. Moher D, "Preferred reporting items for systematic review and meta-analysis protocols(PRISMA-P)2015 statement", Syst Rev, 4, pp.1~ (2015)
  19. Sterne JA, "ROBINS-I : a tool for assessing risk of bias in non-randomised studies of interventions", BMJ, 355, pp.i4919~ (2016)
  20. McGuinness LA, "Risk-of-bias VISualization(robvis) : an R package and Shiny web app for visualizing risk-of-bias assessments", Res Synth Methods, 12, pp.55~61 (2021)
  21. Tahamiler R, "Comparison of the long-term efficacy of subcutaneous and sublingual immunotherapies in perennial rhinitis", ORL J Otorhinolaryngol Relat Spec, 70, pp.144~150 (2008)
  22. Eifan AO, "Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic", rhinitis children sensitized to house dust mite : an open randomized controlled trial, 2010, pp.40, 922~932
  23. Karakoc-Aydiner E, "Long-term effect of sublingual and subcutaneous immunotherapy in dust mite-allergic children with asthma", rhinitis : a 3-year prospective randomized controlled trial, 2015, pp.25, 334~342
  24. Wang ZX, "Single-allergen sublingual immunotherapy versus multi-allergen subcutaneous immunotherapy for children with allergic rhinitis", J Huazhong Univ Sci Technolog Med Sci, 37, pp.407~411 (2017)
  25. You SH, "Comparison study of subcutaneous immunotherapy and sublingual immunotherapy in patients with allergic rhinitis", Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 30, pp.689~693 (2016)
  26. Liu W, "Compliance, efficacy, and safety of subcutaneous and sublingual immunotherapy in children with allergic rhinitis", Pediatr Allergy Immunol, 32, pp.86~91 (2021)
  27. Zhu L, "Compliance and safety evaluation of subcutaneous versus sublingual immunotherapy in mite-sensitized patients with allergic rhinitis", Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 45, pp.444~449 (2010)
  28. Mungan D, "Comparison of the efficacy of subcutaneous and sublingual immunotherapy in mite-sensitive patients with rhinitis and asthma--a placebo controlled study", Ann Allergy Asthma Immunol, 82, pp.485~490 (1999)
  29. Epstein TG, "Current evidence on safety and practical considerations for administration of sublingual allergen immunotherapy(SLIT)in the United States", J Allergy Clin Immunol Pract, 5, pp.34~40 (2017)
  30. Calderon MA, "Allergen injection immunotherapy for seasonal allergic rhinitis", Cochrane Database Syst Rev, 2007, pp.CD001936~ (2007)
  31. Durham SR, "Sublingual or subcutaneous immunotherapy for allergic rhinitis?", J Allergy Clin Immunol, 137, pp.339~349 (2016)
  32. Passalacqua G, "Adherence to pharmacological treatment and specific immunotherapy in allergic rhinitis", Clin Exp Allergy, 43, pp.22~28 (2013)

관련 논문AI추천

알레르기 질환에서 피하면역주사요법과 설하면역요법김선태대한이비인후과학회 부산,울산,경남 지부회 · 임상이비인후과2011 · 제22권 제2호알레르기비염의 치료에 있어서의 설하면역요법의 역할김성완, 정수영대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2014 · 제2권 제2호통년성 알레르기비염 환자에서의 3년간 면역요법 후 3개월 마다 실시한 장기간 면역요법의 효과：삶의 질 평가를 통한 연구김성완, 문지호, 신승엽, 조중생, 차창일, 황명구대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2003 · 제46권 제9호알레르기비염에서 면역요법의 현재와 미래이재서대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2005 · 제48권 제11호알레르기성 호흡기 질환에서의 항원특이면역요법강성윤, 양민석, 이상민, 이상표대한내과학회 · 대한내과학회지2020 · 제95권 제6호대한천식알레르기학회 설하면역요법 진료지침강성윤, 고영일, 김경훈, 김선태, 김주희, 남동호, 류광희, 민진영, 박경희, 박소영, 박중원, 성명순, 신유섭, 심정연, 안영민, 양은애, 이상민, 이영수, 이용원, 이화영, 정은희, 지혜미, 최선희, 최정희, 하은교, 한두희, 한만용, 대한천식알레르기학회 면역요법/알레르겐연구팀대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2024 · 제12권 제3호

이 간행물의 다른 논문 (7건)

집먼지진드기로 유발되는 알레르기비염에서 피하면역요법과 설하면역요법의 비교이상민pp. 1-2알레르기비염과 위생가설최선희, 김현희, 이용주, 김민지, 박용민, 최봉석, 신윤호, 이경석, 김효빈, 전윤홍, 염혜영, 성명순, 지혜미, 나영호, 박 양, 대한 소아알레르기 호흡기학회 비염 연구회pp. 3-8면역글로불린 E 매개 밀 알레르기의 업데이트김정희, 황윤하pp. 9-16소아 알레르기질환에서 감작 패턴에 따른 혈중 호산구와 총 IgE의 비교양은애, 김환수, 전윤홍, 이혜진, 김현희pp. 26-30ImmunoCAP 및 ImmunoCAP Immuno Solid-phase Allergen Chip을 이용하여 lipid transfer protein 증후군으로 진단된 6세 남아의 희귀 증례황윤하, 이상훈pp. 31-34
원문 보기