From Skin to Solution: Exploring Epicutaneous Immunotherapy for Peanut Allergy —A Systematic Review and Meta-Analysis

AbstractPeanut allergy is a leading cause of severe food reactions. This meta-analysis evaluates the efficacy and safety of epicutaneous immunotherapy (EPIT) compared to placebo for peanut-allergic individuals. After prospectively registering on PROSPERO, we searched three databases (PubMed, Google Scholar, and Cochrane CENTRAL) and 2 trial registries till September 2023. Analysis was conducted via RevMan where data was computed using risk ratios (RR). The Cochrane Risk of Bias tool and GRADE criteria were used to appraise and evaluate the evidence. From 4927 records, six multicenter randomized placebo-controlled trials comprising 1453 participants were included. The 250  µg EPIT group had a significant increase in successful desensitization compared to placebo (RR: 2.13 (95% C.I: 1.72, 2.64),P <  0.01,I2 = 0%), while the 100 µg EPIT group did not (RR: 1.54 (95% C.I: 0.92, 2.58),P = 0.10,I2 = 0%) (moderate certainty evidence). Moreover, there was a significant increase in local (RR: 1.69 (95% C.I: 1.06, 2.68),P = 0.03,I2 = 89%) and systemic adverse events (RR: 1.75 (95% C.I: 1.14, 2.69),P = 0.01,I2 = 0%) with EPIT. Additionally, individuals administered EPIT have an increased probability of requiring rescue medications like epinephrine (RR: 1.91 (95% C.I: 1.12, 3.28),P = 0.02,I2 = 0%) and topical corticosteroids (RR: 1.49 (95% C.I: 1.29, 1.73),P <  0.01,I2 = 0%) to treat adverse events. The association of adverse event...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research