Allergy Asthma Clin Immunol:白三烯受体拮抗剂与选择性H1-抗组胺药治疗过敏性鼻炎:当前证据的元分析

2021-07-21 AlexYang MedSci原创

过敏性鼻炎(AR)是一种常见的过敏性疾病,由接触过敏原导致的免疫球蛋白E(IgE)相关的鼻膜炎症引起。根据症状的持久性,AR可分为季节性和常年性。AR患者受鼻腔和眼睛症状的影响,干扰了他们的日常生活和

过敏性鼻炎(AR)是一种常见的过敏性疾病,由接触过敏原导致的免疫球蛋白E(IgE)相关的鼻膜炎症引起。根据症状的持久性,AR可分为季节性和常年性。AR患者受鼻腔和眼睛症状的影响,干扰了他们的日常生活和睡眠时间,从而导致QoL受损。

关于白三烯受体拮抗剂(LTRAs)和选择性H1-抗组胺药(SAHs)治疗过敏性鼻炎(AR)的有效性和安全性仍然存在不一致的结论。近期, 有研究人员对随机对照试验(RCTs)进行了元分析,比较了这些药物的疗效

通过检索PubMed、Embase和Cochrane's Library数据库,搜索了从开始到2020年4月20日的相关的比较性RCTs。研究人员采用了随机效应模型来汇集结果,并对季节性和常年性AR进行了亚组分析。

研究纳入了14项RCTs,包括4458名患者。在日间鼻腔症状评分方面(平均差异[MD]:0.05,95%置信区间[CI]0.02至0.08,P=0.003,I2=89%)和日间眼部症状评分(MD:0. 05, 95%CI 0.01至0.08, p=0.009, I2=89%),LTRAs不如SAHs;但在夜间症状评分方面则LTRAs更优(MD: - 0.04, 95%CI -0.06至-0.02, p<0.001, I2=85%)。两种治疗方法对综合症状评分(MD:0.02,95%CI - 0.02至0.05,p=0.30,I2=91%)和鼻结膜炎生活质量问卷(RQLQ)(MD:0.01,95%CI -0.05至0.07,p=0.71,I2=99%)的影响类似。不良事件的发生率相当(几率[OR]:0.97,95%CI 0.75至1.25,P=0.98,I2=0%)。这些结果主要来自对季节性AR的研究,且没有发现明显的出版偏倚。

LTRAs和SAHs的效果比较

综上所述,尽管两种治疗方法在改善AR患者的生活质量(QoL)方面都是安全有效的,但与SAHs相比,LTRAs在改善夜间症状方面更有效,但在改善白天的鼻腔症状方面效果较差

原始出处:

Yan Feng, Ya-Ping Meng, Ying-Ying Dong et al. Management of allergic rhinitis with leukotriene receptor antagonists versus selective H1-antihistamines: a meta-analysis of current evidence. Allergy Asthma Clin Immunol. Jun 2021

 

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    2022-04-20 skhzy
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  7. 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  8. 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  9. 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  10. 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