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Oral antihistamines for the symptom of nasal obstruction in persistent allergic rhinitis--a systematic review of randomized controlled trials.

AbstractBACKGROUND:
Oral antihistamines are recommended by a World Health Organisation working group as a first-line pharmacological treatment in mild persistent allergic rhinitis. There is, however, uncertainty with respect to their effectiveness for a common symptom, that of nasal obstruction.
OBJECTIVE:
To test the null hypothesis that oral antihistamines have no effect on the symptom of nasal obstruction in a clinical setting in patients with persistent allergic rhinitis.
METHODS:
Protocol based review of double-blind randomized controlled trials of oral antihistamine (i.e. drugs considered to act as a histamine receptor type-1 antagonist) vs. placebo. A search was carried out for published and unpublished trials. Individuals had to be age 12 years or older (with a diagnosis confirmed by skin prick tests, IgE blood tests or nasal allergen challenge), experiencing their normal allergen exposure. A symptom score for nasal obstruction had to be recorded. Predetermined quality criteria were applied. Treating their data as 4-point scores, a meta-analysis was carried out for studies, which provided enough data to be pooled.
RESULTS:
Meta-analysis found a weighted mean difference of -0.52 in favour of treatment for patient-assessed symptom scores (95% confidence interval (CI)-0.73,-0.31, P<0.00001), and of -0.33 in favour of treatment for healthcare worker assessed scores (95% CI -0.49, -0.16, P = 0.0001).
CONCLUSION:
Oral antihistamines cause statistically significant improvement in the symptom of nasal obstruction in patients with persistent allergic rhinitis.
AuthorsI Hore, C Georgalas, G Scadding
JournalClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy) Vol. 35 Issue 2 Pg. 207-12 (Feb 2005) ISSN: 0954-7894 [Print] England
PMID15725193 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
Chemical References
  • Histamine H1 Antagonists
Topics
  • Administration, Oral
  • Adolescent
  • Adult
  • Double-Blind Method
  • Histamine H1 Antagonists (administration & dosage, therapeutic use)
  • Humans
  • Middle Aged
  • Nasal Obstruction (drug therapy, immunology)
  • Patient Selection
  • Randomized Controlled Trials as Topic
  • Rhinitis, Allergic, Perennial (complications, drug therapy)
  • Treatment Outcome

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