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Efficacy but not effectiveness of sublingual immunotherapy for grass pollen allergy: Time to avoid waste in health-care expenditure

  • Salvatore Corrao
    Correspondence
    Corresponding author at: Dipartimento BioMedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), Via del Vespro, 141, 90127 Palermo, Italy.
    Affiliations
    Dipartimento BioMedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), Università degli Studi di Palermo, Italy

    Centre of Research for Effectiveness and Appropriateness in Medicine (C.R.E.A.M.), Italy

    National Relevance Hospital Trust ARNAS Civico, Di Cristina e Benfratelli, Palermo, Italy
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  • Danilo Di Bona
    Affiliations
    Unità Operativa di Immunoematologia e Medicina Trasfusionale Azienda, Ospedaliera Universitaria Policlinico di Palermo, Italy

    Dipartimento di Scienze Statistiche e Matematiche “S. Vianelli”, Università degli Studi di Palermo, Italy
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  • Gabriele Di Lorenzo
    Affiliations
    Dipartimento BioMedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), Università degli Studi di Palermo, Italy
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Published:September 13, 2015DOI:https://doi.org/10.1016/j.ejim.2015.08.018
      Last June JAMA Internal Medicine published an excellent systematic review and meta-analysis of clinical trials of sublingual immunotherapy for grass pollen allergy [
      • Di Bona D.
      • Plaia A.
      • Leto-Barone M.S.
      • La Piana S.
      • Di Lorenzo G.
      Efficacy of grass pollen allergen sublingual immunotherapy tablets for seasonal allergic rhinoconjunctivitis: a systematic review and meta-analysis.
      ]. The team of Di Lorenzo of the University of Palermo reached an important result indicating a small, unimpressive effect of sublingual immunotherapy. These findings probably justify no longer this kind of intervention to be paid by any European health care system. Accordingly, the Editor of JAMA has thrown a “caveat emptor” [
      • O'Malley P.G.
      Caveat emptor on sublingual immunotherapy.
      ] that is similar to a scream towards public welfare managers.

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