title: A Network Meta-analysis of Randomized Controlled Trials Focusing on Different Allergic Rhinitis Medications.
abstract: This study is aimed to investigate the effectiveness of 4 allergic rhinitis (AR) drugs (loratadine, cetirizine, montelukast, and desloratadine) in reducing functional problems in patients, as indicated by rhinoconjunctivitis quality of life questionnaire scores. After an exhaustive search of electronic databases containing published scientific literature, high-quality randomized controlled trials relevant to our study were selected based on a stringent predefined inclusion and exclusion criteria. Statistical analyses were conducted using STATA 12.0 and comprehensive meta-analysis (CMA 2.0) software. The literature search broadly identified 386 studies, and after a multistep screening and elimination process, a total of 13 randomized controlled trials contributed to this network meta-analysis. These 13 high-quality studies contained a combined total of 6867 patients with AR on 4 different medications. The results of network meta-analysis revealed that, compared with placebo, all 4 mediations treated AR effectively [cetirizine: mean: -0.62, 95% confidence intervals (95% CI) = -0.90 to -0.34, P < 0.001; loratadine: mean: -0.32, 95% CI = -0.55 to -0.097, P = 0.005; montelukast: mean: -0.28, 95% CI = -0.54 to -0.023, P = 0.033; desloratadine: mean: -0.39, 95% CI = -0.60 to -0.18, P < 0.001]. A comparison of surface under the cumulative ranking curve values of these 4 interventions clearly showed that cetirizine is the most optimal medication for AR treatment. In conclusion, this network meta-analysis provides the first evidence that cetirizine is the most efficacious treatment for AR compared with loratadine, montelukast, and desloratadine, significantly reducing the functional problems in patients with AR.
authors: 1Department of Liver Transplantation, The First Hospital of Zhejiang University, Hangzhou, China; 2Departments of Science and Education; 3The Operating Room; and 4Departments of Orthopaedic, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors: Juan
authors: J
authors: Xiao
authors: Wen-Xu
authors: WX
authors: Wu
authors: Yuan-Yuan
authors: YY
authors: Ye
authors: Wen-Jun
authors: WJ
authors: Lin
authors: Lu
authors: L
authors: Wang
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D017332:Cetirizine / Q000627:therapeutic use; D003521:Cyclopropanes; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D017336:Loratadine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011788:Quality of Life; D011804:Quinolines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D065631:Rhinitis, Allergic / Q000188:drug therapy*; D013440:Sulfides
chemical_list: D000085:Acetates; D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D039563:Histamine H1 Antagonists, Non-Sedating; D011804:Quinolines; D013440:Sulfides; D017336:Loratadine; C121345:desloratadine; C093875:montelukast; D017332:Cetirizine