The journal of allergy and clinical immunology. In practice · 2024
Intranasal Versus Oral Treatments for Allergic Rhinitis: A Systematic Review With Meta-Analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Torres Maria Inês, Gil-Mata Sara, Bognanni Antonio, Ferreira-da-Silva Renato, Yepes-Nuñez Juan José, Lourenço-Silva Nuno, Cardoso-Fernandes António, Ferreira André, Ferreira-Cardoso Henrique, Portela Diana, Teles João, Kvedariene Violeta, Torres María Jose, Klimek Ludger, Pfaar Oliver, Brussino Luisa, Zuberbier Torsten, Fonseca João A, Schünemann Holger, Bousquet Jean, Sousa-Pinto Bernardo, Vieira Rafael José, Allergic Rhinitis and its Impact on Asthma 2024 Guideline Panel
Аннотация
BACKGROUND: Treatments for allergic rhinitis include intranasal or oral medications.
OBJECTIVE: To perform a systematic review with meta-analysis comparing the effectiveness of intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists in improving allergic rhinitis symptoms and quality of life.
METHODS: We searched four bibliographic databases and three clinical trial datasets for randomized controlled trials (1) assessing patients aged 12 years and older with seasonal or perennial allergic rhinitis, and (2) comparing intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists. We performed a meta-analysis of the Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), development of adverse events, and withdrawals owing to adverse events. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation.
RESULTS: We included 35 studies, most of which assessed patients with seasonal allergic rhinitis and displayed an unclear risk of bias. Superiority of intranasal treatments was found for all assessed outcomes. Intranasal corticosteroids were more effective than oral antihistamines at improving the TNSS (mean difference [MD], -0.86; 95% CI, -1.21 to -0.51; I2 = 70%), Total Ocular Symptom Score (MD, -0.36; 95% CI, -0.56 to -0.17; I2 = 0%), and RQLQ (MD, -0.88; 95% CI, -1.15 to -0.61; I2 = 0%), which were mostly associated with clinically meaningful improvements. Superiority of intranasal corticosteroids at improving the TNSS was also found against oral leukotriene receptor antagonists (MD, -1.05; 95% CI, -1.33 to -0.77). Intranasal antihistamines were more effective than oral antihistamines at improving the TNSS (MD, -0.47; 95% CI, -0.81 to -0.14; I2 = 0%) and RQLQ (MD, -0.31; 95% CI, -0.56 to -0.06; I2 = 0%).
CONCLUSIONS: Randomized controlled trials suggest that intranasal treatments are more effective than oral treatments at improving symptoms and quality of life in seasonal allergic rhinitis.
OBJECTIVE: To perform a systematic review with meta-analysis comparing the effectiveness of intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists in improving allergic rhinitis symptoms and quality of life.
METHODS: We searched four bibliographic databases and three clinical trial datasets for randomized controlled trials (1) assessing patients aged 12 years and older with seasonal or perennial allergic rhinitis, and (2) comparing intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists. We performed a meta-analysis of the Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), development of adverse events, and withdrawals owing to adverse events. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation.
RESULTS: We included 35 studies, most of which assessed patients with seasonal allergic rhinitis and displayed an unclear risk of bias. Superiority of intranasal treatments was found for all assessed outcomes. Intranasal corticosteroids were more effective than oral antihistamines at improving the TNSS (mean difference [MD], -0.86; 95% CI, -1.21 to -0.51; I2 = 70%), Total Ocular Symptom Score (MD, -0.36; 95% CI, -0.56 to -0.17; I2 = 0%), and RQLQ (MD, -0.88; 95% CI, -1.15 to -0.61; I2 = 0%), which were mostly associated with clinically meaningful improvements. Superiority of intranasal corticosteroids at improving the TNSS was also found against oral leukotriene receptor antagonists (MD, -1.05; 95% CI, -1.33 to -0.77). Intranasal antihistamines were more effective than oral antihistamines at improving the TNSS (MD, -0.47; 95% CI, -0.81 to -0.14; I2 = 0%) and RQLQ (MD, -0.31; 95% CI, -0.56 to -0.06; I2 = 0%).
CONCLUSIONS: Randomized controlled trials suggest that intranasal treatments are more effective than oral treatments at improving symptoms and quality of life in seasonal allergic rhinitis.