Authors' objectives:

This study aims to assess the effects of specific intra-dermal immunotherapy in people with seasonal rhinitis, asthma or bee sting venom allergy.

Authors' recommendations: Seasonal rhinitis: Study methods differed and examined sensitivity to different allergens. All the studies except two (one included in the meta-analysis1 and one other6) found that immunotherapy improved symptoms compared with placebo. Improvement was reported in the first year after the initial course of immunotherapy, was maintained during subsequent years when maintenance immunotherapy was given and persisted for up to three years after maintenance therapy is withdrawn. The small size of most of the studies and the doubts over methodological quality of all but two of these studies compromise the reliability of the results. Symptom scores were generally based on ocular and nasal symptoms. While these symptoms are clinically relevant, the clinical importance of observed reductions in scores remains uncertain. Seasonal rhinitis is a common condition, yet most studies were on small numbers of people, who were recruited through specialist allergy clinics, not general practice. The populations studied may not, therefore, be representative of people seen in everyday practice. The high compliance rates seen in the studies may not be reproducible in practice. We found no evidence to compare immunotherapy with other treatments for seasonal rhinitis. Asthma: We found good evidence from one systematic review that immunotherapy reduced asthma symptom scores and supplementary medication compared with placebo. We found no reliable comparisons between immunotherapy and other active treatments for asthma. The clinical importance of the reported improvement in symptom scores is uncertain. Few studies employed standard outcome measures. We found insufficient reliable evidence about effects of immunotherapy on lung function. Bee sting venom allergy: We found insufficient evidence from one review of moderate quality about effects of specific immunotherapy in people with severe hypersensitivity to Hymenoptera venom. against the clinical symptoms of re-sting. Meta-analysis may have been inappropriate, because of the implied poor quality and likely heterogeneity of included studies. The review reported that local and systemic reactions to the injections appeared common, but variation in rates of events among studies suggested differences in injection techniques, in definition of reactions and in data recording. We found no evidence to compare immunotherapy with other possible treatments or management strategies for bee venom allergy.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Bazian Ltd, Wessex Institute for Health Research and Development