Efficacy and Safety of Specific Immunotherapy with Aeroallergens in the Management of Atopic Dermatitis: A Systematic Review and Meta-analysis

Background: Specific immunotherapy with standardized aeroallergens can reduce symptoms and increase the quality of life for related allergy patients. This therapy is still controversial for atopic dermatitis (AD). Hence, a meta-analysis to assess efficacy and safety of specific immunotherapy with aeroallergens on patients with AD could provide a clear oversight on advantages and limitations of such treatment . Methods: : We systematically searched PubMed, DOAJ, and Cochrane Central Register of Controlled Trials databases for relevant studies published Randomized controlled trials (RCTs) up to October 2020. Studies involving all ages and gender with AD who treated with specific immunotherapy employing aeroallergens compared with placebo/control. Results: : Seven studies RCTs were identified with 832 participants. Significantly decreased of SCORAD values favoring immunotherapy were observed (MD: -5.42; 95% CI - 10.31, -0.52; p=0.03). VAS score was significantly decrease (MD: -1.21; 95% CI -2.10, -0.31; p=0.008). However, immunotherapy showed no significant local and systemic adverse events ((RR 1.77; 95% CI 0.98, 3.19, p=0.06); (RR 0.69; 95% CI 0.16, 3.01, p=0.62)) and IgG4 Dermatophagoides farinae (MD: 92.36, 95% CI -89.14,273.87; p=0.32). Conclusion: Our five years meta-analysis included small number studies, indicated moderate-level evidence for immunotherapy with standardized extract of aeroallergens is effective and safe for AD patients.