Montelukast in allergic rhinitis: a systematic review and meta-analysis

Background: Only a fraction of patients with allergic rhinitis receive allergen-specific immunotherapy (AIT). AIT is most commonly delivered subcutaneously in a series of injections over 3‐5 years. Common obstacles to completing this therapy include cost and inconvenience. Intralymphatic immunotherapy (ILIT) has been proposed as a faster alternative, which requires as few as three injections spaced 4 weeks apart. Objective: This systematic review and meta-analysis evaluated the current evidence that supports the use of ILIT for allergic rhinitis. Methods: Clinical trials were identified in the published literature by using an electronic search strategy and were evaluated by using a risk of bias tool. Treatment outcome (symptom scores, medication scores, and combined symptom and medication scores) and provocation testing results (nasal provocation and skin-prick testing) were included in a meta-analysis of standardized mean difference with subgrouping by using a random-effects model. Overall adverse event rates were tabulated, and overall risk ratios were calculated by using a random-effects model. Results: We identified 17 clinical trials that met eligibility criteria. The standardized mean difference of ILIT on the symptom and medication score was ‐0.72 (95% confidence interval [CI], ‐0.98 to ‐0.46; p < 0.0001) (n = 10). The standardized mean difference of ILIT on nasal provocation and skin-prick testing was ‐1.00 (95% CI, ‐1.38 to ‐0.61; p < 0.0001) (n = 7) and ‐0.73 (95% CI, ‐0.99 to ‐0.47; p < 0.0001) (n = 7), respectively. No statistically significant heterogeneity was detected. The overall adverse event rate was 39.5% for ILIT and 23.5% for placebo. Also, 98.4% of adverse events were mild. Conclusion: Our meta-analysis demonstrated that ILIT was safe, conferred desensitization to seasonal and nonseasonal allergens, alleviated allergic rhinitis symptoms, and reduced medication use. A larger randomized, double-blind, placebo controlled trial will be necessary for wider adaptation of this form of AIT.

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Effect of particulate matter exposure on the prevalence of allergic rhinitis in children: A systematic review and meta-analysis

Chemosphere ◽

10.1016/j.chemosphere.2020.128841 ◽

2020 ◽

pp. 128841

Author(s):

Lisen Lin ◽

Tianyu Li ◽

Mengqi Sun ◽

Qingqing Liang ◽

Yuexiao Ma ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Particulate Matter ◽

Meta Analysis ◽

Particulate Matter Exposure

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Effectiveness of Acupuncturing at the Sphenopalatine Ganglion Acupoint Alone for Treatment of Allergic Rhinitis: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/6478102 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Qinwei Fu ◽

Lanzhi Zhang ◽

Yang Liu ◽

Xinrong Li ◽

Yepeng Yang ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Disease Classification ◽

Sphenopalatine Ganglion ◽

Control Groups ◽

Vas Score

Aim(s). To evaluate the efficiency of acupuncturing at the sphenopalatine ganglion acupoint alone for treatment of allergic rhinitis. Design. A total of ten online databases were searched to find studies published up to Jan. 2018. Primary outcome measures include the TNSS, the RQLQ score, the VAS score, total effective rate, score for signs and symptoms, and the improvement of disease classification. Study quality of each included article was evaluated by the Cochrane Collaboration risk of bias tool. A meta-analysis was conducted based on the Cochrane systematic review method by using RevMan 5.3 software. Interventions. Acupuncturing SGA alone was the only therapy in experimental group. Interventions in control groups includes sham acupuncture, acupuncturing other regular acupoints, and western medicine. Specific techniques included manual acupuncture and electroacupuncture only. Primary Outcomes. They include TNSS, RQLQ, VAS score, total effective rate, the improvement of disease classification. Results. Ten studies of eight articles involving 1004 participants were included. Result of meta-analysis showed that acupuncturing sphenopalatine ganglion acupoints alone was more effective than control groups. However, several adverse effects were reported. Conclusion. These findings show that acupuncturing the sphenopalatine ganglion acupoint alone has a potential role in alleviating nasal symptoms, improving quality of life for patients, and the effectiveness of acupuncture in the treatment of allergic rhinitis, suggesting it as a considerable therapy for allergic rhinitis. However, more studies are needed to execute a subgroup analysis of various variables and to evaluate the publication bias of the study.

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Effect of Exposure to Cats and Dogs on the Risk of Asthma and Allergic Rhinitis: A Systematic Review and Meta-analysis

American Journal of Rhinology and Allergy ◽

10.1177/1945892420932487 ◽

2020 ◽

Vol 34 (5) ◽

pp. 703-714

Author(s):

Xiaoping Gao ◽

Mei Yin ◽

Pei Yang ◽

Xia Li ◽

Lingling Di ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Cohort Studies ◽

Meta Analysis ◽

Pooled Analysis ◽

Protective Role ◽

Case Control ◽

Favorable Effect ◽

Case Control Studies

Background Controversies persist regarding whether exposure to cat or dog increases the risk of asthma and allergic rhinitis. Objective This meta-analysis aimed to assess the associations between exposure to cats or dogs and the development of asthma and allergic rhinitis. Methods A systematic review was performed to identify case-control and cohort studies before May 2019, evaluating the association between exposure to cats and dogs and the risk of asthma and rhinitis. The risk of bias was assessed using the Newcastle–Ottawa Scale. The odds ratios (ORs) and risk ratios (RRs) were pooled for case-control and cohort studies, respectively. Subgroup analyses were performed on prespecified study-level characteristics. Results The meta-analysis of 34 cohort studies showed a protective role of exposure to cats [RR: 0.88, 95% confidence interval (CI): 0.77–0.99] or dogs (RR: 0.85, 95% CI: 0.73–0.97) in the development of asthma. The subgroup analysis of birth cohort (RR: 0.74, 95% CI: 0.56–0.93) and children population (RR: 0.83, 95% CI: 0.70–0.96) also suggested a favorable role of exposure to dogs in the development of asthma. Pooled evidence from 13 case-control studies indicated no significant impact of cats (OR: 1.66, 95% CI: 0.39–2.94) and dogs (OR: 1.22, 95% CI: 0.92–1.52) on the development of asthma. A pooled analysis of five cohort studies showed a favorable effect of exposure to cats (RR: 0.60, 95% CI: 0.33–0.86) or dogs (RR: 0.68, 95% CI 0.44–0.90) on the development of allergic rhinitis. Conclusion The findings indicated a protective effect of exposure to cats and dogs, especially ownership, on the development of asthma and allergic rhinitis.

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History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis

World Allergy Organization Journal ◽

10.1016/j.waojou.2019.100069 ◽

2019 ◽

Vol 12 (10) ◽

pp. 100069 ◽

Cited By ~ 6

Author(s):

Hamid Reza Tohidinik ◽

Narmeen Mallah ◽

Bahi Takkouche

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Meta Analysis ◽

History Of

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The association between allergic rhinitis and risk of rheumatoid arthritis: A systematic review and meta‐analysis

Journal of Evidence-Based Medicine ◽

10.1111/jebm.12393 ◽

2020 ◽

Cited By ~ 1

Author(s):

Nipith Charoenngam ◽

Ben Ponvilawan ◽

Thanitsara Rittiphairoj ◽

Surapa Tornsatitkul ◽

Phuuwadith Wattanachayakul ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Allergic Rhinitis ◽

Meta Analysis

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Intranasal Azelastine and Fluticasone as Combination Therapy for Allergic Rhinitis: Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/0194599819841883 ◽

2019 ◽

Vol 161 (3) ◽

pp. 412-418

Author(s):

Peter M. Debbaneh ◽

Anna K. Bareiss ◽

Sarah K. Wise ◽

Edward D. McCoul

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Combination Therapy ◽

Randomized Controlled Trials ◽

Nasal Spray ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Patient Reported ◽

Symptom Scores

Objective Combination therapy with intranasal azelastine and fluticasone propionate is an option for treatment of allergic rhinitis. This systematic review and meta-analysis examines existing literature to determine efficacy in treating allergic rhinitis compared to monotherapy. Data Sources The PubMed, EMBASE, Cochrane, and MEDLINE databases were systematically searched for randomized controlled trials using AzeFlu nasal spray. Review Methods Randomized, controlled trials that reported symptom relief of allergic rhinitis in males and females of all ages were included. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. Results Systematic review identified 8 articles suitable for review. The risk of bias was generally low. All studies exhibited a greater decrease in patient-reported symptom scores in patients treated with combination therapy compared to monotherapy or placebo. Meta-analysis revealed superiority of combination therapy in reducing Total Nasal Symptom Score compared to placebo (mean change from baseline: −2.41; 95% confidence interval [CI], −2.82 to −1.99; P < .001; I 2 = 60%), azelastine (mean change from baseline: −1.40; 95% CI, −1.82 to −0.98; P < .001; I 2 = 0%), and fluticasone (mean change from baseline: −0.74; 95% CI, −1.17 to −0.31; P < .001; I 2 = 12%). Conclusion Current evidence supports both efficacy and superiority of combination intranasal azelastine and fluticasone in reducing patient-reported symptom scores in patients with allergic rhinitis. Combination nasal spray should be considered as second-line therapy in patients with allergic rhinitis that is not controlled with monotherapy.

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Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/0194599819832277 ◽

2019 ◽

Vol 161 (1) ◽

pp. 18-27 ◽

Cited By ~ 4

Author(s):

Eric L. Wu ◽

William C. Harris ◽

Casey M. Babcock ◽

Bailin H. Alexander ◽

Charles A. Riley ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Relative Risk ◽

English Language ◽

Meta Analysis ◽

Included Study ◽

Pubmed Central ◽

Intranasal Corticosteroids ◽

Language Studies ◽

Increased Risk

Objective Intranasal corticosteroids (INCSs) are widely utilized for the treatment of allergic rhinitis. Epistaxis is a known adverse effect of INCSs, but it is not known if the risk of epistaxis differs among INCSs. Data Sources Systematic review of primary studies identified through Medline, Embase, Web of Science, PubMed Central, and Cochrane databases. Review Methods Systematic review was conducted according to the PRISMA standard. English-language studies were queried through February 1, 2018. The search identified randomized controlled trials of INCSs for treatment of allergic rhinitis that reported incidence of epistaxis. An itemized assessment of the risk of bias was conducted for each included study, and meta-analysis was performed of the relative risk of epistaxis for each INCS. Results Of 949 identified studies, 72 met the criteria for analysis. Meta-analysis demonstrated an overall relative risk of epistaxis of 1.48 (95% CI, 1.32-1.67) for all INCSs. The INCSs associated with the highest risk of epistaxis were beclomethasone hydrofluoroalkane, fluticasone furoate, mometasone furoate, and fluticasone propionate. Beclomethasone aqueous, ciclesonide hydrofluoroalkane, and ciclesonide aqueous were associated with the lowest risk of epistaxis. Conclusions about epistaxis with use of budesonide, triamcinolone, and flunisolide are limited due to the low number of studies and high heterogeneity. Conclusions While a differential effect on epistaxis among INCS agents is not clearly demonstrated, this meta-analysis does confirm an increased risk of epistaxis for patients using INCSs as compared with placebo for treatment of allergic rhinitis.

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