{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:28:04Z","timestamp":1789421284203,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Allergen immunotherapy (<jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content>) with mould extracts has been performed for many years but the final demonstration of its clinical efficacy is still missing, due to the small number of studies and their inconsistent results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To systematically review efficacy and safety of <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> for the treatment of respiratory allergies to moulds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The primary outcomes were safety and reduction of symptoms (Symptom Score, <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>) and medication use (Medication Score, <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>) in patients treated with <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> compared to controls. The strength of the evidence was graded based on the risk of bias, consistency and magnitude of effect, according to the <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content> Working Group's guide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>Medline, Web of Science and the Cochrane Library (through September 2017) supplemented with manual searches of reference lists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Eligibility criteria<\/jats:title><jats:p>Randomized studies of intervention comparing <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> to placebo\/pharmacotherapy. Studies not reporting on our outcome of interest or without a control population were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine studies (168 children, 99 adults; median sample size, 27) met the inclusion criteria. The risk of bias was moderate\u2010to\u2010high in all but one study. Low strength evidence supports the assumption that <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> is effective in reducing symptoms and medication use, with only four of nine studies reporting higher benefit of <jats:styled-content style=\"fixed-case\">AIT <\/jats:styled-content><jats:italic>vs<\/jats:italic>. comparators. The highest benefit of <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> compared to pharmacotherapy\/placebo was reported in studies with a longer follow\u2010up (<jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> from \u22123.96 to \u22123.97 in favour of <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content>) and low risk of bias (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>: 66.3\u00a0\u00b1\u00a013 in <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> group; 186.6\u00a0\u00b1\u00a039 in comparators; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). No difference was reported with respect to study sample size, route of administration, age of participants. Generalised adverse reactions were reported in 12.5% of participants treated with sublingual immunotherapy, and 37.2% of participants treated with subcutaneous immunotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low strength evidence suggests that mould <jats:styled-content style=\"fixed-case\">AIT<\/jats:styled-content> is efficacious for the treatment of respiratory allergies. High\u2010quality studies with an adequate sample size are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.13242","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T08:35:28Z","timestamp":1533630928000},"page":"1391-1401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Efficacy and safety of allergen immunotherapy in patients with allergy to molds: A systematic review"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9728-3806","authenticated-orcid":false,"given":"Danilo","family":"Di Bona","sequence":"first","affiliation":[{"name":"Department of Emergency and Organ Transplantation School and Chair of Allergology and Clinical Immunology University of Bari Aldo Moro Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Frisenda","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation School and Chair of Allergology and Clinical Immunology University of Bari Aldo Moro Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7608-9572","authenticated-orcid":false,"given":"Marcello","family":"Albanesi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation School and Chair of Allergology and Clinical Immunology University of Bari Aldo Moro Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0197-5665","authenticated-orcid":false,"given":"Gabriele","family":"Di Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Internal Medicine University of Palermo Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Filomena","family":"Caiaffa","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Macchia","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation School and Chair of Allergology and Clinical Immunology University of Bari Aldo Moro Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01293.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1997.tb01227.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2003.01783.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2007.28.3016"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-12-71"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01620.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.2840"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.08.012"},{"key":"e_1_2_7_10_1","first-page":"187","volume-title":"Mould Allergy","author":"Domson JF","year":"1984"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(85)90746-8"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_2_7_13_1","unstructured":"Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT Green S eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Updated March 2011.http:\/\/www.cochrane.org\/. Accessed June 30 2017."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1986.tb00289.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1986.tb00336.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(90)90156-X"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0546(02)79147-7"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2007.00589.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.08.007"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2010.532201"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.11.036"},{"key":"e_1_2_7_22_1","first-page":"285","article-title":"Evaluation of efficacy of immunotherapy in children with asthma monosensitized to Alternaria","volume":"53","author":"Kili\u00e7 M","year":"2011","journal-title":"Turk J Pediatr"},{"key":"e_1_2_7_23_1","first-page":"1","article-title":"Alternaria allergy: a three\u2010year controlled study in children treated with immunotherapy","volume":"16","author":"Cantani A","year":"1988","journal-title":"Allergol Immunopathol (Madr)"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2010.03.011"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489415583686"},{"key":"e_1_2_7_26_1","first-page":"55","article-title":"Injective versus sublingual immunotherapy in Alternaria tenuis allergic patients","volume":"6","author":"Bernardis P","year":"1996","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_7_27_1","unstructured":"Multicentre double\u2010blind randomized placebo\u2010controlled parallel\u2010group clinical trial to evaluates the clinical efficacy and safety of immunotherapy with purified major allergen Alt a 1 in patients with allergic rhinoconjunctivitis with or without mild to moderate asthma sensitized the fungus Alternaria alternata. EUCTR2010\u2010024440\u201015\u2010ES. Accessed date: April 2017.https:\/\/www.clinicaltrialsregister.eu\/ctr-search\/trial\/2010-024440-15\/ES\/"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.10.015"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.01.012"},{"key":"e_1_2_7_30_1","first-page":"MR000033","article-title":"Industry sponsorship and research outcome","volume":"12","author":"Lundh A","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e8386"},{"key":"e_1_2_7_32_1","first-page":"162","article-title":"Multicenter double\u2010blind comparative study of terfenadine and cetirizine in hay fever","volume":"2","author":"Caiaffa MF","year":"1992","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13317"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2012.03996.x"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13266"}],"container-title":["Clinical &amp; Experimental Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcea.13242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cea.13242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T17:09:08Z","timestamp":1694884148000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cea.13242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,4]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/cea.13242"],"URL":"https:\/\/doi.org\/10.1111\/cea.13242","archive":["Portico"],"relation":{},"ISSN":["0954-7894","1365-2222"],"issn-type":[{"value":"0954-7894","type":"print"},{"value":"1365-2222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,4]]},"assertion":[{"value":"2018-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}