Authors' objectives: To assess the effectiveness, safety and cost-effectiveness of to assess the effectiveness, safety and cost-effectiveness of sublingual immunotherapy for atopy (allergic rhinitis, eczema and asthma).

Authors' results and conclusions: Based from the review, SLIT showed a significant benefit in term of reducing symptoms and medications used, but inconclusive results when comparing between sub cutaneous (SCIT) and sub lingual in treating patients with AR. Adverse events were common with both SCIT and SLIT and majority were local reactions at the point of administration and resolved spontaneously without treatment. For patients with asthma, there was uncertain benefit showed for reducing the exacerbations/ hospital ED visits and medications score, but SLIT demonstrated safe option for people with well-controlled mild-to-moderate asthma and rhinitis. Meanwhile, for patients with AE, the included studies showed inconclusive results to suggest the use of SLIT as an option treatment. In term of cost effectiveness, the were results SLIT is more economically when compared to placebo and other usual care. Based on the our cost calculation, the estimated annual cost of allergy immunotherapy HDM SLIT tablet per patient is between MYR4,823.00 to MYR5,918.00. To achieve the disease modification, a recommended treatment of three years will incur an estimated cost between MYR13,729.00 to MYR17,014.00 per patient. Since the recommended indication of this tablet is for those who are not adequately controlled with standard pharmacotherapy, the expected total expenditure will be based on the prevalence of this population.

Authors' recommendations: SLIT may be used as an option treatment in allergic rhinitis patients or allergic rhinoconjunctivitis with or without mild to moderate asthma. A proper selection of patient to ensure optimum benefit of the SLIT treatment is needed.

Authors' methods: Electronic databases were searched through the Ovid interface; Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to March 31, 2022. Searches were also run in PubMed, INAHTA and Cochrane Library. Google was used to search for additional web-based materials and information. Additional articles were identified from reviewing the references of retrieved articles. Last search was conducted on March 31, 2022.

Authors' identified further research: None

Project Status: Completed

Year Published: 2022

URL for published report: https://www.moh.gov.my/index.php/database_stores/store_view_page/30/409

Requestor: Ministry of Health

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment Section (MaHTAS)