Concomitant corticosteroid nasal spray plus antihistamine (oral or local spray) for the symptomatic management of allergic rhinitis
The purpose of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the symptomatic management of corticosteroid nasal spray plus antihistamine (oral or local spray) with that of either therapy given alone, or placebo in patients with alle...
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| Veröffentlicht in: | European archives of oto-rhino-laryngology 2016-11, Vol.273 (11), p.3477-3486 |
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| creator | Feng, Shaoyan Fan, Yunping Liang, Zibin Ma, Renqiang Cao, Wanwei |
| description | The purpose of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the symptomatic management of corticosteroid nasal spray plus antihistamine (oral or local spray) with that of either therapy given alone, or placebo in patients with allergic rhinitis (AR). The PRISMA guidelines for meta-analysis reporting were followed. Total nasal symptom scores and individual nasal symptom scores were pooled after assessing heterogeneity among studies. The pooled estimates were expressed as weighted mean differences (WMD) between treatments. A total of ten studies fulfilled eligibility. Three trials studied the combination therapy of corticosteroid nasal spray and oral antihistamine. Pooled results of two trials failed to show significant difference on total nasal symptoms between combination therapy and intranasal corticosteroid alone (WMD = −0.20, 95 % CI −0.38 to −0.01,
P
= 0.04). The qualitative analysis showed that combination therapy has greater efficacy than oral antihistamines alone or placebo in improving symptoms. Seven trials investigated corticosteroid nasal spray plus antihistamine nasal spray. The cumulative meta-analysis of six RCTs revealed that combination therapy was superior to solo intranasal corticosteroid (WMD = −1.16, 95 % CI −1.49 to −0.83,
P
|
| doi_str_mv | 10.1007/s00405-015-3832-1 |
| format | Article |
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P
= 0.04). The qualitative analysis showed that combination therapy has greater efficacy than oral antihistamines alone or placebo in improving symptoms. Seven trials investigated corticosteroid nasal spray plus antihistamine nasal spray. The cumulative meta-analysis of six RCTs revealed that combination therapy was superior to solo intranasal corticosteroid (WMD = −1.16, 95 % CI −1.49 to −0.83,
P
< 0.00001), solo intranasal antihistamine (WMD = −1.73, 95 % CI −2.08 to −1.38,
P
< 0.00001), and placebo (WMD = −2.81, 95 % CI −3.16 to −2.47,
P
< 0.00001) in improving total nasal symptom scores. Intranasal corticosteroid plus oral antihistamine have similar efficacy to intranasal corticosteroid alone, greater efficacy than oral antihistamines alone or placebo in reducing nasal symptoms for AR patients. Intranasal corticosteroid plus intranasal antihistamine are significantly superior to either therapy given alone, or placebo.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-015-3832-1</identifier><identifier>PMID: 26545381</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Administration, Intranasal ; Adrenal Cortex Hormones - administration & dosage ; Aerosols ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Head and Neck Surgery ; Histamine Antagonists - administration & dosage ; Histamine H1 Antagonists - administration & dosage ; Humans ; Male ; Medicine ; Medicine & Public Health ; Nasal Sprays ; Neurosurgery ; Otorhinolaryngology ; Randomized Controlled Trials as Topic ; Review Article ; Rhinitis, Allergic - drug therapy ; Rhinitis, Allergic, Seasonal - drug therapy</subject><ispartof>European archives of oto-rhino-laryngology, 2016-11, Vol.273 (11), p.3477-3486</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-80753c69e956922abf0c7f3b07b5b66ea942306bd2943c0b0f18d62d5f4f5f2b3</citedby><cites>FETCH-LOGICAL-c344t-80753c69e956922abf0c7f3b07b5b66ea942306bd2943c0b0f18d62d5f4f5f2b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-015-3832-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-015-3832-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26545381$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feng, Shaoyan</creatorcontrib><creatorcontrib>Fan, Yunping</creatorcontrib><creatorcontrib>Liang, Zibin</creatorcontrib><creatorcontrib>Ma, Renqiang</creatorcontrib><creatorcontrib>Cao, Wanwei</creatorcontrib><title>Concomitant corticosteroid nasal spray plus antihistamine (oral or local spray) for the symptomatic management of allergic rhinitis</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>The purpose of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the symptomatic management of corticosteroid nasal spray plus antihistamine (oral or local spray) with that of either therapy given alone, or placebo in patients with allergic rhinitis (AR). The PRISMA guidelines for meta-analysis reporting were followed. Total nasal symptom scores and individual nasal symptom scores were pooled after assessing heterogeneity among studies. The pooled estimates were expressed as weighted mean differences (WMD) between treatments. A total of ten studies fulfilled eligibility. Three trials studied the combination therapy of corticosteroid nasal spray and oral antihistamine. Pooled results of two trials failed to show significant difference on total nasal symptoms between combination therapy and intranasal corticosteroid alone (WMD = −0.20, 95 % CI −0.38 to −0.01,
P
= 0.04). The qualitative analysis showed that combination therapy has greater efficacy than oral antihistamines alone or placebo in improving symptoms. Seven trials investigated corticosteroid nasal spray plus antihistamine nasal spray. The cumulative meta-analysis of six RCTs revealed that combination therapy was superior to solo intranasal corticosteroid (WMD = −1.16, 95 % CI −1.49 to −0.83,
P
< 0.00001), solo intranasal antihistamine (WMD = −1.73, 95 % CI −2.08 to −1.38,
P
< 0.00001), and placebo (WMD = −2.81, 95 % CI −3.16 to −2.47,
P
< 0.00001) in improving total nasal symptom scores. Intranasal corticosteroid plus oral antihistamine have similar efficacy to intranasal corticosteroid alone, greater efficacy than oral antihistamines alone or placebo in reducing nasal symptoms for AR patients. Intranasal corticosteroid plus intranasal antihistamine are significantly superior to either therapy given alone, or placebo.</description><subject>Administration, Intranasal</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Aerosols</subject><subject>Double-Blind Method</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Head and Neck Surgery</subject><subject>Histamine Antagonists - administration & dosage</subject><subject>Histamine H1 Antagonists - administration & dosage</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nasal Sprays</subject><subject>Neurosurgery</subject><subject>Otorhinolaryngology</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Review Article</subject><subject>Rhinitis, Allergic - drug therapy</subject><subject>Rhinitis, Allergic, Seasonal - drug therapy</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1vFDEQhi0EIpeEH0CDXCbFwvhzd0t0ghApEg2pLa_XvnO0thfbW1zNH8fRJZRUI808847mQegjgc8EoP9SADiIDojo2MBoR96gHeGMd7yn8i3awcj6jvO-v0CXpTwBgOAje48uqBRcsIHs0J99iiYFX3Ws2KRcvUml2pz8jKMuesFlzfqE12UruDH-6EvVwUeLb1Ju45Txkswrd4tda9SjxeUU1pqCboE46KgPNth2Ijmsl8XmQ2vno4---nKN3jm9FPvhpV6hx-_ffu1_dA8_7-73Xx86wziv3QC9YEaOdhRypFRPDkzv2AT9JCYprR45ZSCnmY6cGZjAkWGWdBaOO-HoxK7QzTl3zen3ZktVwRdjl0VHm7aiyEClZFKIoaHkjJqcSsnWqTX7oPNJEVDP7tXZvWru1bN7RdrOp5f4bQp2_rfxKrsB9Aw0VT4ebFZPacuxvfyf1L_iHZGy</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Feng, Shaoyan</creator><creator>Fan, Yunping</creator><creator>Liang, Zibin</creator><creator>Ma, Renqiang</creator><creator>Cao, Wanwei</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161101</creationdate><title>Concomitant corticosteroid nasal spray plus antihistamine (oral or local spray) for the symptomatic management of allergic rhinitis</title><author>Feng, Shaoyan ; Fan, Yunping ; Liang, Zibin ; Ma, Renqiang ; Cao, Wanwei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-80753c69e956922abf0c7f3b07b5b66ea942306bd2943c0b0f18d62d5f4f5f2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Administration, Intranasal</topic><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Aerosols</topic><topic>Double-Blind Method</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Head and Neck Surgery</topic><topic>Histamine Antagonists - administration & dosage</topic><topic>Histamine H1 Antagonists - administration & dosage</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nasal Sprays</topic><topic>Neurosurgery</topic><topic>Otorhinolaryngology</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Review Article</topic><topic>Rhinitis, Allergic - drug therapy</topic><topic>Rhinitis, Allergic, Seasonal - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feng, Shaoyan</creatorcontrib><creatorcontrib>Fan, Yunping</creatorcontrib><creatorcontrib>Liang, Zibin</creatorcontrib><creatorcontrib>Ma, Renqiang</creatorcontrib><creatorcontrib>Cao, Wanwei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feng, Shaoyan</au><au>Fan, Yunping</au><au>Liang, Zibin</au><au>Ma, Renqiang</au><au>Cao, Wanwei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concomitant corticosteroid nasal spray plus antihistamine (oral or local spray) for the symptomatic management of allergic rhinitis</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>273</volume><issue>11</issue><spage>3477</spage><epage>3486</epage><pages>3477-3486</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>The purpose of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the symptomatic management of corticosteroid nasal spray plus antihistamine (oral or local spray) with that of either therapy given alone, or placebo in patients with allergic rhinitis (AR). The PRISMA guidelines for meta-analysis reporting were followed. Total nasal symptom scores and individual nasal symptom scores were pooled after assessing heterogeneity among studies. The pooled estimates were expressed as weighted mean differences (WMD) between treatments. A total of ten studies fulfilled eligibility. Three trials studied the combination therapy of corticosteroid nasal spray and oral antihistamine. Pooled results of two trials failed to show significant difference on total nasal symptoms between combination therapy and intranasal corticosteroid alone (WMD = −0.20, 95 % CI −0.38 to −0.01,
P
= 0.04). The qualitative analysis showed that combination therapy has greater efficacy than oral antihistamines alone or placebo in improving symptoms. Seven trials investigated corticosteroid nasal spray plus antihistamine nasal spray. The cumulative meta-analysis of six RCTs revealed that combination therapy was superior to solo intranasal corticosteroid (WMD = −1.16, 95 % CI −1.49 to −0.83,
P
< 0.00001), solo intranasal antihistamine (WMD = −1.73, 95 % CI −2.08 to −1.38,
P
< 0.00001), and placebo (WMD = −2.81, 95 % CI −3.16 to −2.47,
P
< 0.00001) in improving total nasal symptom scores. Intranasal corticosteroid plus oral antihistamine have similar efficacy to intranasal corticosteroid alone, greater efficacy than oral antihistamines alone or placebo in reducing nasal symptoms for AR patients. Intranasal corticosteroid plus intranasal antihistamine are significantly superior to either therapy given alone, or placebo.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26545381</pmid><doi>10.1007/s00405-015-3832-1</doi><tpages>10</tpages></addata></record> |
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| ispartof | European archives of oto-rhino-laryngology, 2016-11, Vol.273 (11), p.3477-3486 |
| issn | 0937-4477 1434-4726 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Administration, Intranasal Adrenal Cortex Hormones - administration & dosage Aerosols Double-Blind Method Drug Therapy, Combination Female Head and Neck Surgery Histamine Antagonists - administration & dosage Histamine H1 Antagonists - administration & dosage Humans Male Medicine Medicine & Public Health Nasal Sprays Neurosurgery Otorhinolaryngology Randomized Controlled Trials as Topic Review Article Rhinitis, Allergic - drug therapy Rhinitis, Allergic, Seasonal - drug therapy |
| title | Concomitant corticosteroid nasal spray plus antihistamine (oral or local spray) for the symptomatic management of allergic rhinitis |
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