Evidence map›Paper›PMID 40538627›Full record

SynthesisFrontiers in allergy2025

Efficacy of index of reactivity-liquid sublingual immunotherapy in allergic rhinoconjunctivitis: a systematic review and meta-analysis of randomized studies.

Danilo Di Bona, Andrea Di Biase, Giovanni Paoletti, Rosanna Villani, Gaetano Serviddio, Josiane Cognet-Sicé, Silvia Scurati, Giorgio Walter Canonica

Erratum issuedAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Danilo Di BonaDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Andrea Di BiaseDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Giovanni PaolettiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
Rosanna VillaniDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Gaetano ServiddioDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Josiane Cognet-SicéIntegrated Health Care Department, Stallergenes Greer, Antony, France.
Silvia ScuratiIntegrated Health Care Department, Stallergenes Greer, Antony, France.
Giorgio Walter CanonicaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Allergen immunotherapy (AIT) is a well-established treatment with demonstrated efficacy and safety. However, variability in study outcomes remains a challenge, driven by differences in patient characteristics, study designs, and treatment durations. Moreover, disparities in allergen composition and quality of AIT products across manufacturers contribute to significant heterogeneity, complicating the interpretation of efficacy and safety data. This meta-analysis focuses on assessing the efficacy and safety of a single manufacturer's liquid sublingual immunotherapy (SLIT) for allergic rhinoconjunctivitis (ARC). By narrowing the scope to one specific product, this study seeks to reduce variability linked to product differences, aligning with recommendations from the World Allergy Organization to improve the reliability of meta-analytic findings. Methods: Randomized controlled trials (RCTs) on index of reactivity (IR) SLIT liquid formulations of various allergens were identified through comprehensive searches in electronic databases (MEDLINE, ISI Web of Science, the Cochrane Library, and ClinicalTrial.gov) up to December 2024, complemented by manual searches. Data on populations, treatments, and outcomes were extracted. Efficacy was evaluated by calculating the standardized mean difference (SMD) for symptoms and medication use. Subgroup analyses were performed by age, allergen type and sensitization status. Asthma comorbidity, dose and duration of SLIT were evaluated using meta-regression. Results: A total of 25 RCTs (1,830 patients) provided data on symptom scores (SS), and 19 RCTs (1,555 patients) reported on medication scores (MS). Analysis revealed that IR-SLIT-liquid was significantly more effective than placebo in reducing both SS (SMD: -0.30; 95% CI: -0.41 to -0.18; Discussion: This meta-analysis underscores the clinical effectiveness and safety of IR-SLIT-liquid, confirming its role as a reliable etiologic treatment for patients with ARC, for all allergens and age groups. The effect size is comparable to other immunotherapy options. The low rates of adverse events and treatment withdrawals highlight favorable tolerability and high level of patient adherence. Systematic Review Registration: https://inplasy.com/wp-content/uploads/2025/01/INPLASY-Protocol-7305.pdf, INPLASY 202510049.

Indexed as

allergicmeta-analysisrandomized controlled trialrhinitisSLIT-liquidsublingual immunotherapysystematic review

Identifiers

PMID40538627
PMCPMC12176734

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.