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Antihistamines for treating rhinosinusitis: systematic review and meta-analysis of randomised controlled studies

  • K Seresirikachorn (a1), L Khattiyawittayakun (a1), W Chitsuthipakorn (a2) and K Snidvongs (a1)
Abstract
Background:

Without the release of histamines, patients with rhinosinusitis may not benefit from antihistamines. Additionally, anticholinergic effects may do more harm than good. This study aimed to investigate the effectiveness of antihistamines in treating rhinosinusitis.

Methods:

An electronic search was performed. Randomised controlled trials comparing antihistamines with either placebo or other treatments for patients with rhinosinusitis were selected.

Results:

Two studies (184 patients) met the inclusion criteria. Loratadine decreased nasal obstruction in allergic rhinitis patients with acute rhinosinusitis (mean difference = −0.58; confidence interval = −0.85 to −0.31, p < 0.01), but had no benefit on total symptom score (mean difference = −1.25; confidence interval = −2.77 to 0.27, p = 0.11), or rhinorrhoea symptoms (mean difference = −0.06; confidence interval = −0.37 to 0.25, p = 0.71).

Conclusion:

There is limited evidence to support the use of antihistamines in treating rhinosinusitis. The number of included studies in this systematic review is limited. Antihistamines may relieve nasal obstruction in allergic rhinitis patients with acute rhinosinusitis.

Copyright
Corresponding author
Address for correspondence: Dr Kornkiat Snidvongs, Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand Fax: +66 2 252 7787 E-mail: drkornkiat@yahoo.com
References
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1 Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:112
2 Wallwork, B, Coman, W, Mackay-Sim, A, Greiff, L, Cervin, A. A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis. Laryngoscope 2006;116:189–93
3 Van Zele, T, Gevaert, P, Holtappels, G, Beule, A, Wormald, PJ, Mayr, S et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol 2010;125:1069–76
4 Naclerio, RM, Proud, D, Kagey-Sobotka, A, Lichtenstein, LM, Hendley, JO, Gwaltney, JM Jr. Is histamine responsible for the symptoms of rhinovirus colds? A look at the inflammatory mediators following infection. Pediatr Infect Dis J 1988;7:218–22
5 Wang, DY, Wardani, RS, Singh, K, Thanaviratananich, S, Vicente, G, Xu, G et al. A survey on the management of acute rhinosinusitis among Asian physicians. Rhinology 2011;49:264–71
6 Higgins, JP, Green, S, eds. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 (updated March 2011). Copenhagen: Cochrane Collaboration, 2011
7 Review Manager (RevMan) [computer program]. Version 5.1.6. Copenhagen: Nordic Cochrane Centre, Cochrane Collaboration, 2011
8 Braun, JJ, Alabert, JP, Michel, FB, Quiniou, M, Rat, C, Cougnard, J et al. Adjunct effect of loratadine in the treatment of acute sinusitis in patients with allergic rhinitis. Allergy 1997;52:650–5
9 Haye, R, Aanesen, JP, Burtin, B, Donnelly, F, Duby, C. The effect of cetirizine on symptoms and signs of nasal polyposis. J Laryngol Otol 1998;112:1042–6
10 Hore, I, Georgalas, C, Scadding, G. Oral antihistamines for the symptom of nasal obstruction in persistent allergic rhinitis--a systematic review of randomized controlled trials. Clin Exp Allergy 2005;35:207–12
11 Ciprandi, G, Cirillo, I, Vizzaccaro, A, Tosca, MA. Levocetirizine improves nasal obstruction and modulates cytokine pattern in patients with seasonal allergic rhinitis: a pilot study. Clin Exp Allergy 2004;34:958–64
12 Jang, YJ, Wang, JH, Kim, JS, Kwon, HJ, Yeo, NK, Lee, BJ. Levocetirizine inhibits rhinovirus-induced ICAM-1 and cytokine expression and viral replication in airway epithelial cells. Antivir Res 2009;81:226–33
13 McCormick, DP, John, SD, Swischuk, LE, Uchida, T. A double-blind, placebo-controlled trial of decongestant-antihistamine for the treatment of sinusitis in children. Clin Pediatr (Phila) 1996;35:457–60
14 Shaikh, N, Wald, ER. Decongestants, antihistamines and nasal irrigation for acute sinusitis in children. Cochrane Database Syst Rev 2014;(10):CD007909
15 De Sutter, AI, Saraswat, A, van Driel, ML. Antihistamines for the common cold. Cochrane Database Syst Rev 2015;(11):CD009345
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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