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Cited by 26Allergic Rhinitis and SensitizationAsthma and respiratory diseasesFood Allergy and Anaphylaxis Research

The Effectiveness of Modern Antihistamines for Treatment of Allergic Rhinitis - An IPD Meta-Analysis of 140,853 Patients

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Mösges, Ralph, König, Volker, Köberlein, Juliane·2013·Allergology International
DOI 10.2332/allergolint.12-oa-0486
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Abstract

BACKGROUND: Allergic rhinitis represents a worldwide health problem. The prevalence is increasing. The aim of this study was to analyse the correlation between the severity of allergic rhinitis and an adequate treatment dose of modern oral antihistamines. METHODS: From a comprehensive databank containing data from ten different open-label prospective observational studies including raw data of 140,853 patients with allergic rhinitis, symptomatology variables were analysed and scored to study the effects of treatment with four antihistamines (Desloratadine, Ebastine, Fexofenadine, Levocetirizine) alone or in combination with intranasal corticosteroids. The patient data were collected in 23,606 study centres from Germany, mostly medical specialist and some primary care physicians in private practice. The analyses were performed via individual patient data meta-analysis techniques. RESULTS: Finally 92,900 patient data from nine of ten studies could be analysed. One study with data of 47,953 patients was excluded due to incomplete treatment documentation. Both monotherapy analysis subgroups (Total Symptom Score and Total Nasal Symptom Score) were significantly better than those of their combinations with intranasal steroids. Monotherapy with levocetirizine was determined to be significantly more effective in lowering the Total Symptom Score (p < 0.001) and the Total Nasal Symptom Score (p < 0.05) than the other antihistamines. In the next stage, a greater positive effect of levocetirizine was demonstrated in relation to the severity of the clinical symptoms of allergic rhinitis (Total Nasal Symptom Score in cases with severe symptomatology [effect size = -0.09]). CONCLUSIONS: Levocetirizine asserted itself as the only antihistamine compared with the others as significant in this analysis. The study authors recommend monotherapy with the new-generation antihistamine levocetirizine, especially in severe cases of allergic rhinitis.

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  • Both oral and intranasal H1 antihistamines have shown efficacy in NO in patients with allergic rhinitis, although the magnitude of benefit is modest compared with decongestants and intranasal corticosteroids.

    “Both oral and intranasal anti-H 1 have shown efficacy in NO in patients with AR [142,143], although the magnitude of the benefit is modest compared with decongestants and INCs [144].”

    From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [142]

    The Results report a trend toward reduced nasal obstruction with the oral antihistamine levocetirizine, but the Discussion says this symptom-specific finding was not statistically significant. The Objectives and Study Design section says intranasal antihistamine studies were excluded; the paper also does not compare antihistamine benefit with decongestants. Although the Introduction describes intranasal corticosteroids as more effective for nasal symptoms, it does not establish the claimed comparison for both oral and intranasal antihistamines. (LLM, conf=0.87)

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Research works printed but not linked: 24

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Cited by

Sorted by citations

Authors
Mösges, R., König, V., & Köberlein, J.
Affiliations
University of Cologne (DE)
Venue
Allergology International
Publisher
Japanese Society of Allergology
Published
2013
Volume
62
Issue
2
Pages
215-222
ISSN
1323-8930 (ISSN-L)
DOI
10.2332/allergolint.12-oa-0486
OpenAlex
W1975146618
Cited by
26
References
0
Citations by year
2024: 2 · 2023: 4 · 2022: 5 · 2021: 1 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 3 · 2013: 1
FWCI
0.42
Type
journal article
Language
en
Open access
Licence
Locations
  • Allergology International (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Sanofi
  • Sanofi-Aventis Deutschland
  • UCB Pharma
Topics
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
Keywords
allergic rhinitis, antihistamines, levocetirizine, desloratadine, ebastine, fexofenadine, intranasal corticosteroids, monotherapy, symptom scores, nasal symptom score, treatment effectiveness, symptom severity
MeSH terms
Histamine Antagonists, Humans, Prospective Studies, Rhinitis, Allergic, Perennial, Nasal Obstruction, Treatment Outcome, Cetirizine, Anti-Allergic Agents, Histamine H1 Antagonists, Non-Sedating, Rhinitis, Allergic

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