Efficacy of Grass Pollen Allergen Sublingual Immunotherapy Tablets for XXXX : A Systematic Review and Meta-analysis.

@entity1 @entity7126 @entity1425 @entity13366 @entity56 @entity922 @entity288
IMPORTANCE: @entity922 ( @entity922 ) and meta-analyses of @entity13366 ( @entity13366 ) for the treatment of @entity56 ( @entity56 ) have shown a modest clinical benefit compared with placebo. Furthermore, indirect comparison by meta-analyses showed that subcutaneous immunotherapy is more effective than @entity13366 . Despite these data, @entity13366 has become the most prescribed treatment of @entity56 in Europe in recent years, and it was approved by the US Food and Drug Administration for the treatment of @entity56 to grass pollen in the United States on April 1, 2014. OBJECTIVE: To assess the efficacy and safety of the grass pollen sublingual tablets licensed as drugs in the treatment of @entity1 with @entity56 to grass pollen. DATA SOURCES: Computerized bibliographic searches of MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov (from inception to April 30, 2014) were supplemented with a manual search of reference lists. STUDY SELECTION: @entity922 were included if they compared the grass pollen @entity13366 tablets approved by regulatory authorities in the European Union and the United States for @entity56 with placebo. DATA EXTRACTION AND SYNTHESIS: Data on populations, interventions, and outcomes were extracted from each RCT according to the intent-to-treat method by 2 independent observers and were combined using the method by DerSimonian and Laird. MAIN OUTCOMES AND MEASURES: The primary end point was the difference in the symptom score and medication score between @entity13366 and placebo. We pooled data using random-effects meta-analysis, with standardized mean differences (SMDs) and 95% CIs reported. RESULTS: Data were available in 13 @entity922 for the symptom score (4659 @entity1 ) and in 12 @entity922 for the medication score (4558 @entity1 ). We found a small treatment benefit in the symptom score ( @entity7126 , -0.28; 95% CI, -0.37 to -0.19; P   <   .001) and in the medication score ( @entity7126 , -0.24; 95% CI, -0.31 to -0.17; P   <   .001). Adverse events were reported in 1384 of 2259 @entity1 (61.3%) receiving @entity13366 and in 477 of 2279 @entity1 (20.9%) receiving placebo. Seven @entity1 in the @entity13366 group reported treatment-related adverse events requiring @entity1425 . CONCLUSIONS AND RELEVANCE: Findings show a small benefit of the grass pollen sublingual tablets in reducing symptoms and in decreasing the use of symptomatic medication (antihistamines and @entity288 ) in @entity1 with @entity56 . Considering the low magnitude of the benefit, the convenience and easy administration do not seem to be sufficient reasons for the choice of @entity13366 .
