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Oral antihistamines for the symptom of nasal obstruction in persistent allergic rhinitis – a systematic review of randomized controlled trials
Author(s) -
Hore I.,
Georgalas C.,
Scadding G.
Publication year - 2005
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2005.02159.x
Subject(s) - medicine , antihistamine , placebo , randomized controlled trial , confidence interval , allergen , allergy , loratadine , meta analysis , dermatology , anesthesia , immunology , alternative medicine , pathology
Summary Background Oral antihistamines are recommended by a World Health Organisation working group as a first‐line pharmacological treatment in mild persistent allergic rhinitis. There is, however, uncertainty with respect to their effectiveness for a common symptom, that of nasal obstruction. Objective To test the null hypothesis that oral antihistamines have no effect on the symptom of nasal obstruction in a clinical setting in patients with persistent allergic rhinitis. Methods Protocol based review of double‐blind randomized controlled trials of oral antihistamine (i.e. drugs considered to act as a histamine receptor type‐1 antagonist) vs. placebo. A search was carried out for published and unpublished trials. Individuals had to be age 12 years or older (with a diagnosis confirmed by skin prick tests, IgE blood tests or nasal allergen challenge), experiencing their normal allergen exposure. A symptom score for nasal obstruction had to be recorded. Predetermined quality criteria were applied. Treating their data as 4‐point scores, a meta‐analysis was carried out for studies, which provided enough data to be pooled. Results Meta‐analysis found a weighted mean difference of −0.52 in favour of treatment for patient‐assessed symptom scores (95% confidence interval (CI)−0.73,−0.31, P <0.00001), and of −0.33 in favour of treatment for healthcare worker assessed scores (95% CI −0.49, −0.16, P =0.0001). Conclusion Oral antihistamines cause statistically significant improvement in the symptom of nasal obstruction in patients with persistent allergic rhinitis.