Table 9 Evidence models used to establish guidelines for sublingual immunotherapy
From: Sublingual immunotherapy: World Allergy Organization position paper 2013 update
Year | Evidence model | No. of RCTs* | Recommendation | |
|---|---|---|---|---|
Specific guidelines on immunotherapy** | ||||
WHO consensus [278] | 1989 | None | 0 | None |
EAACI 1988 guidelines [279] | 1988 | None | 0 | None |
EAACI 1992 [280] | 1992 | None | 0 | None |
WHO Position Paper [281] | 1998 | None | 2 | None |
EAACI Local | 1998 | None | 4 | Suggested in adults |
Immunotherapy [282] | ||||
AAAAI/ACAAI Practice parameters [283] | 2007 | Shekelle [284] | 14 | SLIT as investigational in US (no FDA approval yet) |
Canadian guidelines[285] | 2006 | None | 10 | SLIT evaluated positively as ‘novel form’, but no recommendation given |
Argentinean guidelines[286] | 2010 | None † | No review | Indications on IT in general (AR, AC, Asthma) as co-treatment with medication. Extra indication for SLIT if SCIT is not tolerated/acceptable |
AAAAI/ACAAI Practice parameters[102] | 2011 | Shekelle[284] | 9 | SLIT as investigational in US (No FDA approval yet) |
British guidelines[287] | 2011 | SIGN | 25 | SLIT for adults and children with AR, after treatment failure with medication and avoidance. |
Mexican guidelines[288] | 2011 | GRADE | 18 | Recommend SLIT for adults and children with AR and asthma; suggest for some cases of atopic dermatitis, latex allergy, and large local reactions to hymenoptera venom. |
Chinese expert consensus on AIT for AR[289] | 2011 | Consensus | ? | ? |
Finnish update on current care guidelines: AIT[290] | 2012 | ? | ? | Indicated for AR caused by grass pollen. Oral tolerance induction in children older than 5 y with severe food allergy. |
Other guidelines in which immunotherapy is mentioned | ||||
ARIA 2001 [291] | 2001 | Shekelle [284] | 12 | Recommended in adults, suggested in children |
ARIA Update 2008 [159] | 2008 | Shekelle [284] | 36 | Indicated in the same conditions as SCIT: patients with rhinitis/conjunctivitis/asthma caused by pollen or HDM; patients who have presented systemic reactions during SCIT. |
ARIA Update 2010[292] | 2010 | GRADE | 63 | Suggests the use of pollen and HDM SLIT for allergic rhinitis in adults and of pollen SLIT in children. Does not suggest HDM SLIT in children for treatment of AR. Suggests SLIT in patients with AR+Asthma for asthma treatment (low quality evidence). |
GA2LEN/EAACI pocket guide for AIT[293] | 2010 | Based on WAO IT papers and ARIA 2001, 2008, and 2010 | No new review | |
BSACI guidelines on Hymenoptera venom allergy[294] | 2011 | NICE accredited | 0 | SLIT for venom immunotherapy is mentioned as a future research area. |
Guidelines for treatment of atopic eczema of the European Academy of Dermatology and Venereology[295] | 2012 | Appraisal of Guidelines Research and Evaluation and DELPHI procedure. | 0 (this is a Review of Guidelines not RCTs) | Allergen IT (not stating SLIT or SCIT) to aeroallergens may be useful in selected cases of atopic eczema. |