Background

Currently, a combination of intranasal corticosteroid (INCS) plus oral H₁ antihistamine (OAH) or intranasal H₁ antihistamine (INAH) therapy is frequently used in the treatment of allergic rhinitis (AR). The superiority of the 2 combined treatments needs to be further examined.

Objective

To identify the better of the 2 therapeutic strategies for treating AR.

Methods

A literature review was performed on MEDLINE, Cochrane Library, and EMBASE databases. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses, meta-analyses of the total nasal symptom scores and individual nasal symptom scores were pooled based on studies that compared concomitant H₁ antihistamines plus INCS with INCS alone in the treatment of AR. The pooled results were expressed as weighted mean differences between the treatments. For each selected study, we calculated the relative clinical impact based on the total nasal symptom scores as follows: 100 × (Score_Monotherapy − Score_{Combined therapy}) / Score_Monotherapy.

Results

A total of 13 publications met our selection criteria, with 5066 patients. The pooled results revealed no significant weighted mean difference on the total nasal symptom scores between concomitant OAH plus INCS and INCS alone. As for the individual symptoms, the most common symptom that revealed remission was rhinorrhea, which was after OAH in combination with INCS. The combination therapy of INAH and INCS was superior to INCS alone. In an indirect comparison, the weighted mean relative clinical impact of INAH plus INCS was significantly higher than that of OAH plus INCS.

Conclusion

Intranasal H₁ antihistamines have an add-on effect on intranasal corticosteroids, and the combination of intranasal H₁ antihistamines plus intranasal corticosteroid is superior to that of oral H₁ antihistamines plus intranasal corticosteroid in improving nasal symptoms for patients with AR.

中文翻译：

---

鼻内抗组胺药优于口服H1抗组胺药，可作为鼻内皮质类固醇治疗过敏性鼻炎的附加疗法。

背景

当前，鼻内皮质类固醇（INCS）加口服H ₁抗组胺药（OAH）或鼻内H ₁抗组胺药（INAH）的组合经常用于过敏性鼻炎（AR）的治疗。这两种联合治疗的优越性有待进一步研究。

目的

为了确定治疗AR的2种治疗策略中更好的一种。

方法

在MEDLINE，Cochrane Library和EMBASE数据库上进行了文献综述。根据系统评价和荟萃分析的首选报告项目的指导原则，汇总了鼻总症状评分和个体鼻症状评分的荟萃分析，这些研究基于比较H ₁抗组胺药联合INCS与单独INCS的治疗研究。 AR。合并结果表示为处理之间的加权平均差。对于每项选择的研究，我们根据总的鼻部症状评分计算出相对临床影响，如下：100×（_单项 评分-_综合评分）/_单项评分。

结果

共有13篇出版物符合我们的选择标准，有5066名患者。汇总的结果显示，伴随的OAH加INCS和单独的INCS在总的鼻部症状评分上没有显着的加权平均差异。至于个体症状，最明显的症状是鼻出血，这是OAH与INCS联用后发生的。INAH和INCS的联合治疗优于单独的INCS。在间接比较中，INAH + INCS的加权平均相对临床影响显着高于OAH + INCS。

结论

鼻内H ₁抗组胺药对鼻内皮质类固醇有附加作用，鼻内H ₁抗组胺药加鼻内皮质类固醇的组合优于口服H ₁抗组胺药加鼻内皮质类固醇在改善AR患者鼻腔症状方面。