Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis
Abstract Background There is ongoing debate about the safety and efficacy of epicutaneous immunotherapy (EPIT) in treating food allergies. The systematic review and meta-analysis aimed to evaluate the safety and efficacy of EPIT. Methods We systematically searched international trial registers (Clin...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13643-024-02727-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559811393585152 |
|---|---|
| author | Xiaohong Xiang Jingwei Hu Rangui Sachu Chonghua Gao Hongyan Niu Yi Gao Shiju Chen Xiaotian Cui Xiang Li |
| author_facet | Xiaohong Xiang Jingwei Hu Rangui Sachu Chonghua Gao Hongyan Niu Yi Gao Shiju Chen Xiaotian Cui Xiang Li |
| author_sort | Xiaohong Xiang |
| collection | DOAJ |
| description | Abstract Background There is ongoing debate about the safety and efficacy of epicutaneous immunotherapy (EPIT) in treating food allergies. The systematic review and meta-analysis aimed to evaluate the safety and efficacy of EPIT. Methods We systematically searched international trial registers (ClinicalTrials.gov), PubMed, Embase, the Cochrane Central of Controlled Trials (CENTRAL), and Web of Science from the inception of the database until June 25, 2023. Two authors independently screened potential studies based on the following criteria: food allergy, epidermal immunotherapy, and randomized controlled trials(RCTs). The risk-of-bias assessment was performed using the Cochrane risk-of-bias 2 (ROB 2) tool. The primary outcomes included desensitization, local adverse events, systemic adverse events, and quality of life. Secondary outcomes included epinephrine utilization, topical medication utilization, and severe adverse events. We assessed certainty of evidence by the GRADE approach. Results Ten studies involving 1970 participants were included. Ten high-quality RCTs focusing on peanut allergy and cow’s milk allergy were included in the analysis. The meta-analysis revealed that EPIT promoted desensitization in patients with food allergy (RR 2.11, 95% CI 1.72–2.58; I 2 = 0%, high certainty), particularly in aged ≤ 11 years (RR 3.84, 95% CI 2.39–6.26; I 2 = 34%). Additionally, treatment duration ≥ 52 weeks was found to increase immune tolerance (RR 3.37, 95% CI 2.39–4.75; I 2 = 13%). Patients who undergo EPIT treatment not only raised the local adverse reactions (RR 1.63, 95% CI 1.10–2.41; I 2 = 82%, low certainty) but also raised systemic adverse reactions (RR 1.52, 95% CI 1.01–2.28; I 2 = 0%, high certainty). Conclusion After EPIT treatment, patients with food allergy can effectively increase their immune tolerance to food. However, it also significantly increases mild-to-moderate anaphylaxis. There is limited data on the impact of EPIT on quality of life and other food allergic diseases, indicating a need for further research. |
| format | Article |
| id | doaj-art-64080cf307904f79b2734cc43c695a8d |
| institution | Kabale University |
| issn | 2046-4053 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj-art-64080cf307904f79b2734cc43c695a8d2025-01-05T12:09:59ZengBMCSystematic Reviews2046-40532025-01-0114111010.1186/s13643-024-02727-6Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysisXiaohong Xiang0Jingwei Hu1Rangui Sachu2Chonghua Gao3Hongyan Niu4Yi Gao5Shiju Chen6Xiaotian Cui7Xiang Li8Department of Pediatric, Affiliated Chifeng Clinical College of Inner, Mongolia Medical UniversityDepartment of Pediatric, Chifeng Municipal HospitalDepartment of Pediatric, Chifeng Municipal HospitalDepartment of Pediatric, Chifeng Municipal HospitalDepartment of Pediatric, Chifeng Municipal HospitalDepartment of Anesthesiology, Affiliated Chifeng Clinical College of Inner, Mongolia Medical UniversityGraduate School, Hainan Medical UniversityDepartment of Pediatric, Affiliated Chifeng Clinical College of Inner, Mongolia Medical UniversityDepartment of Pediatric, Affiliated Chifeng Clinical College of Inner, Mongolia Medical UniversityAbstract Background There is ongoing debate about the safety and efficacy of epicutaneous immunotherapy (EPIT) in treating food allergies. The systematic review and meta-analysis aimed to evaluate the safety and efficacy of EPIT. Methods We systematically searched international trial registers (ClinicalTrials.gov), PubMed, Embase, the Cochrane Central of Controlled Trials (CENTRAL), and Web of Science from the inception of the database until June 25, 2023. Two authors independently screened potential studies based on the following criteria: food allergy, epidermal immunotherapy, and randomized controlled trials(RCTs). The risk-of-bias assessment was performed using the Cochrane risk-of-bias 2 (ROB 2) tool. The primary outcomes included desensitization, local adverse events, systemic adverse events, and quality of life. Secondary outcomes included epinephrine utilization, topical medication utilization, and severe adverse events. We assessed certainty of evidence by the GRADE approach. Results Ten studies involving 1970 participants were included. Ten high-quality RCTs focusing on peanut allergy and cow’s milk allergy were included in the analysis. The meta-analysis revealed that EPIT promoted desensitization in patients with food allergy (RR 2.11, 95% CI 1.72–2.58; I 2 = 0%, high certainty), particularly in aged ≤ 11 years (RR 3.84, 95% CI 2.39–6.26; I 2 = 34%). Additionally, treatment duration ≥ 52 weeks was found to increase immune tolerance (RR 3.37, 95% CI 2.39–4.75; I 2 = 13%). Patients who undergo EPIT treatment not only raised the local adverse reactions (RR 1.63, 95% CI 1.10–2.41; I 2 = 82%, low certainty) but also raised systemic adverse reactions (RR 1.52, 95% CI 1.01–2.28; I 2 = 0%, high certainty). Conclusion After EPIT treatment, patients with food allergy can effectively increase their immune tolerance to food. However, it also significantly increases mild-to-moderate anaphylaxis. There is limited data on the impact of EPIT on quality of life and other food allergic diseases, indicating a need for further research.https://doi.org/10.1186/s13643-024-02727-6Food allergyEpicutaneous immunotherapySystematic reviewsMeta-analyses |
| spellingShingle | Xiaohong Xiang Jingwei Hu Rangui Sachu Chonghua Gao Hongyan Niu Yi Gao Shiju Chen Xiaotian Cui Xiang Li Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis Systematic Reviews Food allergy Epicutaneous immunotherapy Systematic reviews Meta-analyses |
| title | Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis |
| title_full | Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis |
| title_fullStr | Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis |
| title_full_unstemmed | Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis |
| title_short | Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis |
| title_sort | epicutaneous immunotherapy for food allergy a systematic review and meta analysis |
| topic | Food allergy Epicutaneous immunotherapy Systematic reviews Meta-analyses |
| url | https://doi.org/10.1186/s13643-024-02727-6 |
| work_keys_str_mv | AT xiaohongxiang epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT jingweihu epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT ranguisachu epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT chonghuagao epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT hongyanniu epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT yigao epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT shijuchen epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT xiaotiancui epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis AT xiangli epicutaneousimmunotherapyforfoodallergyasystematicreviewandmetaanalysis |