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- Title
Effects of H1 antihistamine addition to intranasal corticosteroid for allergic rhinitis: a systematic review and meta‐analysis.
- Authors
Seresirikachorn, Kachorn; Chitsuthipakorn, Wirach; Kanjanawasee, Dichapong; Khattiyawittayakun, Likhit; Snidvongs, Kornkiat
- Abstract
Background: A combination of H1 antihistamine (AH) with intranasal corticosteroid (INCS) is commonly prescribed to patients with allergic rhinitis (AR) who have an inadequate response to monotherapy. In this systematic review we aimed to determine the effects of AH combined with INCS (AH‐INCS) for treating AR. Methods: Literature searches were performed using Medline and Embase. Randomized, controlled trials that studied the effects of AH‐INCS vs INCS monotherapy for treating patients with AR were included. The primary outcomes were total nasal symptom scores, total ocular symptom scores, and disease‐specific quality of life. The secondary outcomes were objective tests for nasal patency and adverse events. Results: Sixteen studies (4026 patients) met the inclusion criteria. Compared with INCS, AH‐INCS decreased total nasal symptom scores (standardized mean difference [SMD], −0.13; 95% confidence interval [CI], −0.19 to −0.06; p < 0.001; 10 trials, 3348 patients) and total ocular symptom scores (SMD, −0.12, 95% CI, −0.20 to −0.04; p = 0.003; 6 trials, 2378 patients). Subgroup analysis indicated no benefit with the oral AH‐INCS combination but did show benefit with intranasal AH‐INCS (SMD, −0.18; 95% CI, −0.27 to −0.09; p < 0.001). There were no significant differences with regard to disease‐specific quality of life (SMD, −0.07; 95% CI, −0.16 to 0.02; p = 0.12; 6 trials, 1981 patients), nasal inspiratory flow (MD, −0.03 L/min; 95% CI, −0.57 to 0.50; p = 0.91; 1 trial, 54 patients), or adverse events. Conclusion: Intranasal AH‐INCS has benefit over INCS on nasal and ocular symptom improvement for treating AR. Oral AH‐INCS is not recommended.
- Subjects
ANTIHISTAMINES; CORTICOSTERONE; ALLERGIC rhinitis; STEROIDS; META-analysis
- Publication
International Forum of Allergy & Rhinology, 2018, Vol 8, Issue 10, p1083
- ISSN
2042-6976
- Publication type
Article
- DOI
10.1002/alr.22166