Pharmacotherapy and immunotherapy of allergic rhinitis induced by house dust mite, grass, and birch pollen allergens: a meta-analysis of randomized clinical trials.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM

Expert Review of Respiratory Medicine Pub Date : 2023-07-01 Epub Date: 2023-07-28 DOI:10.1080/17476348.2023.2241364

Monika Marko, Rafał Pawliczak

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引用次数: 0

Abstract

Background: The aim of this study was to assess the efficacy and safety of oral antihistamines (AHs), intranasal antihistamines (INAH) intranasal glucocorticosteroids (INCS), subcutaneous immunotherapy (SCIT), and sublingual immunotherapy (SLIT) in the management of allergic rhinitis (AR). The authors focused on the division into selected AR's triggers: house dust mites (HDMs), grass pollen, and birch pollen.

Methods: For each drug and allergen class, a meta-analysis of the efficacy and adverse events (AEs) was performed. The obtained results were presented as a therapeutic index (TIX-Score).

Results: Twenty-seven randomized clinical trials (RCTs) were included. The best total efficacy was observed for: HDMs for INCS and grass pollen for combination of INCS with INAH in a single device and for INAH. Considering the data that was obtained for birch pollen, SLIT showed statistically significant total efficacy. Summation scores for efficacy and AEs showed highest TIX-Score for combination of INCS and INAH in a single device in grass pollen.

Conclusions: Treatment methods selected for this review may serve as an effective and safe treatment in reducing perennial and seasonal AR's symptoms. However, due to high heterogeneity probably associated with potential confounders existence in control in some cases, results should be interpreted with caution.

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屋尘螨、草和桦树花粉过敏原诱导的过敏性鼻炎的药物治疗和免疫治疗：一项随机临床试验的荟萃分析。

背景：本研究的目的是评估口服抗组胺药（AHs）、鼻内抗组胺剂（INAH）、鼻内糖皮质激素（INCS）、皮下免疫疗法（SCIT）和舌下免疫疗法（SLIT）治疗过敏性鼻炎（AR）的疗效和安全性。作者重点研究了AR的触发因素：屋尘螨（HDM）、草花粉和桦树花粉。方法：对每种药物和过敏原类别进行疗效和不良事件（AE）的荟萃分析。结果：纳入了27项随机临床试验（RCT）。观察到的最佳总疗效是：HDMs用于INCS，草花粉用于INCS与INAH在单个设备中的组合和INAH。考虑到桦树花粉的数据，SLIT显示出具有统计学意义的总功效。疗效和AE的综合得分显示，在草花粉的单个装置中，INCS和INAH组合的TIX得分最高。结论：本综述中选择的治疗方法可以作为一种有效和安全的治疗方法，减少常年和季节性AR的症状。然而，由于在某些情况下可能与对照中存在的潜在混杂因素相关的高度异质性，应谨慎解释结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity