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Cochrane Review Nixes Specific Allergen Immunotherapy for Atopic Dermatitis

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Key clinical point: The available evidence doesn’t support using specific allergen immunotherapy for atopic dermatitis.

Major finding: A new Cochrane systematic review and meta-analysis has found “no consistent evidence” that specific allergen immunotherapy is more effective than placebo in treating atopic dermatitis.

Data source: This was a Cochrane systematic review and meta-analysis of 12 randomized controlled trials of specific allergen immunotherapy in 733 pediatric and adult atopic dermatitis patients.

Disclosures: The presenter reported having no relevant financial conflicts of interest.


 

AT 2016 AAAAI ANNUAL MEETING

References

LOS ANGELES – A new Cochrane systematic review and meta-analysis has concluded there is no consistent evidence that specific allergen immunotherapy is beneficial in patients with atopic dermatitis, Dr. Herman H. Tam reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

“We know that for specific allergen immunotherapy, there have been really good results in allergic rhinitis and venom allergy. For atopic dermatitis, however, dating back almost 40 years, we found there have only been 12 randomized trials using standardized allergen extracts. The quality of evidence was low, and the study findings have been inconsistent,” Dr. Tam, first author of the Cochrane review, said in an interview.

Dr. Herman H. Tam Bruce Jancin/Frontline Medical News

Dr. Herman H. Tam

The dozen trials included a total of 733 children and adults in nine countries. Because of insufficient follow-up in most of the studies, coupled with the use of a variety of endpoints, the analysis concluded that “specific allergen immunotherapy cannot be recommended for atopic eczema at present” (Cochrane Database Syst Rev. 2016 Feb 12;2:CD008774).

“We found no consistent evidence that specific allergen immunotherapy provides a treatment benefit for people with allergic eczema, compared with placebo or no treatment. The message of this review is that we need more large randomized trials with better controls, modern high-quality allergen extracts that have proven themselves in other allergic diseases, and patient-centered outcome measures,” according to Dr. Tam, who participated in the Cochrane review while at Imperial College London and is now a pediatric resident at the University of Manitoba, Winnipeg.

He reported having no relevant financial conflicts.

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