Clinical Evaluation of Allergen Immunotherapy for Allergic Rhinitis
Por:
Catamerò F, Bragato MC, Alvaro-Lozano M, Canonica GW, Hernández DB, Escribese MM, Heffler E, Pfaar O, Sahiner U, Paoletti G and Giovannini M
Publicada:
7 abr 2026
Ahead of Print:
1 abr 2026
Resumen:
Background/Objectives: Allergen immunotherapy (AIT), involving subcutaneous (SCIT) or sublingual (SLIT) administration of the culprit allergen, is the only treatment capable of modifying the natural course of allergic diseases, and provides lasting benefits in terms of symptom reduction and medication use. AIT for allergic rhinitis is acknowledged as safe and effective in both adults and children; however, no studies have comprehensively evaluated the safety and efficacy of AIT in these populations, integrating results from randomized controlled trials (RCTs) and real-world evidence (RWE). Methods: We evaluated data in the literature including studies from RCTs and RWE in which the safety and efficacy of AIT in both children and adults have been analyzed. A narrative literature search was conducted in PubMed up to January 2026 using the following keywords for the search string: "allergen immunotherapy," "AIT," "safety," "efficacy," "clinical outcome," and "clinical evaluation." Results: RCTs and meta-analyses showed that both SCIT and SLIT significantly reduced allergic symptoms and medication use and improved quality of life (QoL). Large SLIT tablet trials have confirmed its efficacy in adults and children, whereas RWE supports its effectiveness in broader populations. Safety data indicated that SCIT carries a small but higher risk of systemic reactions than SLIT, which mainly causes mild local effects. Conclusions: AIT was effective and safe for treating allergic rhinitis across RCT and RWE studies. Integrating RWE with RCT findings is essential for guideline development, particularly for capturing long-term outcomes and real-world applications.
Filiaciones:
Catamerò F:
Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
Department of Health Sciences, University of Florence, 50139 Florence, Italy
Bragato MC:
Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, 20072 Milan, Italy
Alvaro-Lozano M:
Pediatric Allergology and Clinical Immunology Department, Hospital Sant Joan de Déu, 08950 Barcelona, Spain
Departament de Cirurgia i Especialitats Médico-Quirúrgiques, Universitat de Barcelona, 08950 Barcelona, Spain
Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
Canonica GW:
Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, 20072 Milan, Italy
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
Hernández DB:
Department of Basic Medical Sciences, Institute for Applied Molecular Medicine Nemesio Díez, School of Medicine, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28668 Boadilla del Monte, Spain
RICORS "Red de Enfermedades Inflamatorias (REI)" (RD24/0007/0018), Instituto de Salud Carlos III, 28029 Madrid, Spain
Escribese MM:
Department of Basic Medical Sciences, Institute for Applied Molecular Medicine Nemesio Díez, School of Medicine, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28668 Boadilla del Monte, Spain
RICORS "Red de Enfermedades Inflamatorias (REI)" (RD24/0007/0018), Instituto de Salud Carlos III, 28029 Madrid, Spain
Heffler E:
Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, 20072 Milan, Italy
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
Pfaar O:
Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, 35043 Marburg, Germany
Sahiner U:
Department of Pediatric Allergy, Faculty of Medicine, Hacettepe University, Ankara 06230, Türkiye
Paoletti G:
Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, 20072 Milan, Italy
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
Giovannini M:
Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
Department of Health Sciences, University of Florence, 50139 Florence, Italy
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