Prednisolone versus antihistamine for allergic rhinitis: No significant difference found in randomized trial.

IF 4.6 2区 医学 Q2 ALLERGY Clinical and Translational Allergy Pub Date : 2025-01-01 DOI:10.1002/clt2.70017
Carl Skröder, Laila Hellkvist, Ulla Westin, Pernilla Sahlstrand-Johnsson, Kerstin Hansson, Agneta Karlsson, Åslög Dahl, Leif Bjermer, Lars Olaf Cardell
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Abstract

Background: Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy.

Objective: To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR.

Methods: This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen season. The two groups received either prednisolone tablets (20 mg) or ebastine tablets (20 mg) for 7 days. Treatment effects were evaluated by comparing daily symptom scores, use of topical medication, and a combined symptom-medical score between the groups. Quality of life was recorded at the start and after 3 weeks.

Results: Both interventions demonstrated efficacy in enhancing quality of life metrics. The area under the curve (AUC) for the combined symptom severity and medication usage score averaged 34.0 (SD = 19.1, 95% CI = 24.5-43.4) in the group treated with prednisolone. This was marginally lower than the control group, with an AUC of 32.6 (SD = 13.2, 95% CI = 25.6-39.7). The difference was not statistically significant (p = 0.80). Both groups exhibited only mild adverse events, which were statistically comparable in frequency and severity.

Conclusions: Prednisolone tablets did not show superior efficacy over antihistamine tablets in reducing symptoms or medication usage in tree pollen-induced AR. These results suggest that systemic corticosteroids may not provide additional benefits over antihistamines, and clinicians should prioritize individualized treatment based on patient preferences and tolerability.

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强的松龙与抗组胺药治疗变应性鼻炎:在随机试验中没有发现显著差异。
背景:季节性变应性鼻炎(AR)通过影响工作效率和生活质量影响公众健康。瑞典树木的花粉季节从2月份的桤木和榛子授粉开始,接着是桦树授粉,5月份以橡树授粉结束。当局部治疗失败时,尽管支持其疗效的证据有限,但通常会开全身性皮质类固醇。目的:比较强的松龙片与抗组胺片在减轻中重度树花粉性急性呼吸道感染患者症状和用药方面的疗效。方法:采用介入性单中心、双盲随机试验,纳入34例患者。开始治疗,并在树花粉季节记录症状。两组患者分别服用强的松龙片(20mg)或依巴斯汀片(20mg),疗程7 d。通过比较两组之间的每日症状评分、局部用药的使用以及症状-医学综合评分来评估治疗效果。在治疗开始时和3周后分别记录患者的生活质量。结果:两种干预措施均显示出提高生活质量指标的有效性。强的松龙治疗组症状严重程度与用药综合评分的曲线下面积(AUC)平均为34.0 (SD = 19.1, 95% CI = 24.5-43.4)。这比对照组略低,AUC为32.6 (SD = 13.2, 95% CI = 25.6-39.7)。差异无统计学意义(p = 0.80)。两组均表现出轻微的不良事件,在频率和严重程度上具有统计学可比性。结论:泼尼松龙片在减轻树花粉引起的AR的症状或药物使用方面并没有表现出比抗组胺片更优的疗效。这些结果表明,全身皮质类固醇可能没有比抗组胺药提供额外的益处,临床医生应根据患者的偏好和耐受性优先考虑个体化治疗。
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来源期刊
Clinical and Translational Allergy
Clinical and Translational Allergy Immunology and Microbiology-Immunology
CiteScore
7.50
自引率
4.50%
发文量
117
审稿时长
12 weeks
期刊介绍: Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.
期刊最新文献
Cost-of-illness analysis of chronic urticaria clinical management in five countries of Latin America. Disease control and quality of life in chronic spontaneous urticaria and recurrent angioedema are strongly linked, but not in all patients. The present and future of digital health, digital medicine, and digital therapeutics for allergic diseases. Total immunoglobulin E levels in induced sputum reflect asthma control status. Prednisolone versus antihistamine for allergic rhinitis: No significant difference found in randomized trial.
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