Allergen Immunotherapy Shows Promise for Atopic Dermatitis

In a recent systematic review and meta-analysis published in the Journal of Allergy and Clinical Immunology, researchers provided evidence supporting the benefits of allergen immunotherapy (AIT) for the treatment of atopic dermatitis (AD).

The researchers aimed to evaluate the effects of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in improving AD-related outcomes while considering potential harms. Researchers conducted a comprehensive search of multiple databases for randomized controlled trials assessing the effects of AIT on AD, as part of the 2022 American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Joint Task Force on Practice Parameters AD guideline update. The trials included a total of 23 studies with 1957 adult and pediatric patients primarily sensitized to house dust mites.

The results demonstrated that both SCIT and SLIT as add-on therapies had similar effects, leading to significant improvements in AD severity and quality of life (QoL). Specifically, there was a notable reduction in AD severity, defined as a 50% decrease in SCORing Atopic Dermatitis, with an absolute difference of 14% between AIT and placebo or standard care groups. Similarly, AIT showed a positive impact on QoL, as measured by a 4-point or more improvement in the Dermatology Life Quality Index, with an absolute difference of 17%. Moreover, both SCIT and SLIT were associated with an increased risk of adverse events. Adverse effects were more pronounced with SCIT compared with SLIT.

“SCIT and SLIT to aeroallergens, particularly house dust mite, can similarly and importantly improve AD severity and QoL. SCIT increases adverse effects more than SLIT,” concluded the study authors. “These findings support a multidisciplinary and shared decision-making approach to optimally managing AD.”

Reference
Yepes-Nuñez JJ, Guyatt GH, Gómez-Escobar LG, et al. Allergen immunotherapy for atopic dermatitis: systematic review and meta-analysis of benefits and harms. J Allergy Clin Immunol. 2023;151(1):147-158. doi:10.1016/j.jaci.2022.09.020