Table 32Summary of strength of evidence regarding the effectiveness of sublingual immunotherapy

OutcomeNumber of Studies/Number of ParticipantsOverall Risk of BiasDirection of ChangeConsistencyDirectnessMagnitude of EffectStudiesStrength of Evidence
Asthma Symptoms13/6251 high
8 medium
4 low
13 positiveConsistentDirect10 strong
1 moderate
1 weak
1 CND
2 studies with low RofB AND strong magnitudeHigh
Rhinitis or Rhinoconjunctivitis Symptoms35/26585 high
20 medium
10 low
35 positiveConsistentDirect9 strong
5 moderate
8 weak
13 CND
1 study with low RofB AND strong magnitude
6 studies with medium RofB AND strong magnitude
Moderate
Asthma plus Rhinitis or Rhinoconjunctivitis Combined symptoms5/3085 medium4 positive
1 NR
1 +/− *
ConsistentDirect2 strong
1 moderate
2 CND
2 studies with medium RofB AND strong magnitude
1 study with medium RofB and moderate magnitude
2 studies with medium RofB and magnitude not determinable
Moderate
Conjunctivitis Symptoms13/10742 high
6 medium
5 low
11 positive
1 negative
1 NR
ConsistentDirect3 strong
2 moderate
2 weak
7 CND
5 studies with low RofB AND 1 of these with strong magnitude
6 studies with medium RofB AND 1 of these with strong magnitude
7 studies with insufficient data to determine magnitude of effect
Moderate
Medication Use38/27246 high
22 medium
10 low
33 positive
1 negative
1 NR
3 +/− *
ConsistentDirect13 strong
4 moderate
8 weak
10 CND
3 s/m/w*
10 studies with low RofB; 2 of these with strong magnitude; 2 with low magnitude of effect and 4 of these with magnitude not determinable
22 studies with medium RofB ;7 of these with strong magnitude, 6 of these with low magnitude of effect
6 studies with high RofB AND 3 of these with strong magnitude
9 studies with insufficient data to determine magnitude of effect
Moderate
Combined Medication plus Symptoms19/14624 high
11 medium
4 low
18 positive
1 NR
ConsistentDirect6 strong
5 weak
8 CND
4 studies with low RofB: 1 of these with strong magnitude and 2 with low magnitude
11 studies with medium RofB AND 5 of these with strong magnitude
8 studies with insufficient data to determine magnitude of effect
4 studies with high RofB, 3 of these insufficient data to determine magnitude of effect
Moderate
Disease-Specific Quality of Life8/8192 high
4 medium
2 low
6 positive
1 negative
1 +/−*
ConsistentDirect2 strong
1 moderate
5 CND
4 studies with medium RofB AND 2 of these with strong magnitude
2 studies with low RofB AND insufficient data to determine magnitude of effect
5 studies with insufficient data to determine magnitude of effect
Moderate

+ = positive; − = negative; s: strong, m moderate, w weak CND = could not determine; NR = not reported; RofB = risk of bias

*

Different direction or magnitude depending on comparators.

Different direction or magnitude depending on comparators.

From: Results

Cover of Allergen-Specific Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and/or Asthma: Comparative Effectiveness Review
Allergen-Specific Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and/or Asthma: Comparative Effectiveness Review [Internet].
Comparative Effectiveness Reviews, No. 111.
Lin SY, Erekosima N, Suarez-Cuervo C, et al.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.