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Evidences of efficacy of allergen immunotherapy in atopic dermatitis: an updated review

Compalati, Enrico; Rogkakou, Anthi; Passalacqua, Giovanni; Canonica, Giorgio W.

Current Opinion in Allergy and Clinical Immunology: August 2012 - Volume 12 - Issue 4 - p 427–433
doi: 10.1097/ACI.0b013e328354e540
PHARMACOTHERAPY AND EVIDENCE BASED MEDICINE: Edited by David A. Khan and Enrico Compalati

Purpose of review To update and assess the quality of the evidence concerning the efficacy of allergen immunotherapy for atopic eczema. Desensitization for eczema as a clinical manifestation of food allergy was not a target of this review.

Recent findings In the past 5 years, from the last comprehensive systematic review of Bussmann et al., four controlled trials have been published on this topic, two using injection and two sublingual immunotherapy. The active treatment was compared with placebo, pharmacotherapy or different schedules of immunotherapy. The studies variably involved adults and children and showed an improvement of atopic dermatitis severity. Severe eczema seems less responsive to hyposensitization, and a minimal treatment duration of 9–12 months appears necessary.

Summary The efficacy of immunotherapy in patients with atopic eczema has been poorly investigated in the past 5 years. The available trials have small dimension and some methodological shortcomings, in addition to incomplete reporting. Clinical and methodological interstudy heterogeneity is apparent. Only one study adopted a placebo control. The evidence of efficacy has not critically changed from previous systematic observations. No long-term studies have been conducted to determine the disease-modifying potential of specific immunotherapy in the context of the ‘allergy march’.

Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa, Genova, Italy

Correspondence to Enrico Compalati, MD, PhD, Allergy and Respiratory Disease Clinic, Department of Internal Medicine, University of Genoa, Largo R. Benzi 10, Pad. Maragliano, Genova 16131, Italy. E-mail: enrico.compalati@gmail.com

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.