Sublinguale immunotherapie bij kinderen met astma of rinoconjunctivitis: onvoldoende evidence door matige kwaliteit van de verrichte studies; een systematisch literatuuroverzicht

To determine the evidence of the efficacy and safety of sublingual immunotherapy (SLIT) as a curative therapy for allergies in children.

Design

Systematic review.

Method

All randomised, double blind and placebo-controlled studies (DBRPCT’s) on SLIT in asthma or rhinoconjunctivitis in children were selected from Medline, Embase and Cochrane Central Register of Controlled Trials. Also references of the found articles were used. The selected studies were assessed for quality and the different outcomes were evaluated.

Results

13 DBRPCT’s on SLIT in children were selected, 5 studies on children with house dust mite allergy and 8 studies on children with grass pollen allergy. There was considerable heterogeneity among the different studies with respect to the choice and definition of outcome criteria. The quality of the included studies was moderate. After treatment with SLIT, especially reported symptoms decreased without improvement of objective parameters. Positive results originated especially from significant differences within the intervention group before and after treatment.

Conclusion

It was not possible to substantiate the claim of authors of the studies regarding the favourable effects of SLIT in children with asthma or rhinoconjunctivitis, since all studies had serious methodological flaws. However, the studies showed that SLIT seems to be safe in children in the doses applied.

Ned Tijdschr Geneeskd. 2008;152:261-8