Abstract:
RATIONALE:Evidence-based medicine represents the effort to highlight the best intervention for patients, clinicians, and policy makers, each from their respective viewpoint, to solve a particular health condition. According to a recently diffused grading system of evidence and recommendations for medical interventions, efficacy and safety represent 2 of the most important features to consider, and data from meta-analyses of randomized controlled clinical trials (RCTs) is the strongest supporting demonstration. Fexofenadine has been used for its efficacy and safety in the treatment of allergic rhinitis (AR) for many years although no meta-analyses supporting its use currently exist. The aim of this study is to assess for the first time the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analytic analysis of existing RCTs. Since specific evidence should be provided to address recommendations in a pediatric population, the quality of the estimates of this subgroup analysis is assessed. METHODS:All double-blind, placebo-controlled randomized trials assessing the efficacy of fexofenadine in AR were searched for in OVID, Medline, and Embase databases up to December 2007. Outcomes were extracted from original articles; when this information was not available, the authors of each trial were contacted. Some graphics were digitalized. The RevMan 5 program was used to perform the analysis. GradePro 3.2.2 was used to assess the quality of the evidence for a pediatric population. RESULTS:Of 2,152 identified articles, 20 were potentially relevant trials. Eight studies satisfied the inclusion criteria and were included in the meta-analysis. The main reasons for exclusion were: unnatural exposure, strong study limitations, an atypical outcome measurement, a design for other outcomes, and not being a placebo-controlled, single-blind study. Seven trials investigated a mixed population of adults and children, 1 trial investigated only children, and 1 trial only adults. In 1,833 patients receiving fexofenadine (1,699 placebo), a significant reduction of the daily reflective total symptom scores (TSS) (SMD –0.42; 95% CI –0.49 to –0.35, p < 0.00001) was found. Positive results were also found for morning instantaneous TSS and individual nasal symptom scores (sneezing, rhinorrhea, itching, and congestion). The safety analysis did not show a significant difference in reported adverse events (AE) between the active and placebo treatment groups (OR = 1.03; 95% CI 0.87–1.22, p = 0.75). A very low heterogeneity between the studies was detected, so a fixed-effects model was used. The mean quality level of the included trials was medium. Specific information for a pediatric population may be assumed with a moderate quality of evidence from only 1 study and with a low quality of evidence, mainly due to indirectness, from the others. CONCLUSIONS:This study has 5 major strengths: it represents the first attempt to evaluate the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analysis of RCTs; there was consistency between positive results in terms of efficacy in TSS and in individual symptoms; a large population was studied; there was an irrelevant interstudy heterogeneity, and the AE frequency was similar in both groups. All of these values encourage the recommendation of fexofenadine for AR. Further research focused on the benefits and disadvantages for a pediatric population is needed.
journal_name
Int Arch Allergy Immunoljournal_title
International archives of allergy and immunologyauthors
Compalati E,Baena-Cagnani R,Penagos M,Badellino H,Braido F,Gómez RM,Canonica GW,Baena-Cagnani CEdoi
10.1159/000321896subject
Has Abstractpub_date
2011-01-01 00:00:00pages
1-15issue
1eissn
1018-2438issn
1423-0097journal_volume
156pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:The role of food allergens in the induction of allergic reactions in the airways is not completely understood. The aim of the present study was to evaluate fluorocytometric assays of the peripheral blood during food challenge tests in children with asthma and food allergy. PATIENTS AND METHODS:22 children w...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000226239
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:We analyzed the T cell activation potency and the IgE-binding properties (allergenicity) of nine isoforms of Bet v 1, the major allergen of birch pollen. METHODS:The capacity of recombinant Bet v 1 isoforms to bind serum IgE from allergic patients was evaluated by immunoblot experiments and skin prick tests...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000237524
更新日期:1997-05-01 00:00:00
abstract::A high-dose, accelerated escalation schedule during subcutaneous allergen-specific immunotherapy (AIT) is safe and well-tolerated in adults. However, there are no data in children and adolescents. The aim of the present trial was to assess safety and tolerability of an accelerated dose escalation schedule of an AIT wi...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000512561
更新日期:2021-01-27 00:00:00
abstract:BACKGROUND:Despite parallel increases in asthma and obesity prevalence, there is little data on obesity as a risk factor for atopy. The latter is an important phenotype in asthmatic patients. This study investigates the association between asthma traits, atopy and obesity-related markers in Chinese adolescents. METHOD...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000189196
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Matrix metalloproteinase (MMP)-2, MMP-9 and MMP-13 can degrade type IV collagen which is the major component of the basement membrane zone (BMZ). In bullous pemphigoid (BP), the separation occurs within the BMZ. OBJECTIVE:To evaluate the involvement of MMPs in the pathogenesis of BP, we examined the express...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000090385
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Volatile monoisocyanates are formed through thermal degradation when products containing polyurethane are heated. Repeated exposure to diisocyanates, such as toluene diisocyanate (TDI) are a well-known cause of occupational asthma. However, although monoisocyanates are abundant in occupational settings, ther...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000222675
更新日期:2009-01-01 00:00:00
abstract::Bronchial asthma is characterized by infiltration of the respiratory tracts by eosinophils. A wide variety of adhesion molecules expressed by eosinophils have been proposed to be involved in binding of eosinophils to the vascular endothelium and subsequent transmigration from the circulation to the airways, while litt...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000237722
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Evidence regarding sublingual immunotherapy (SLIT) efficacy and its good safety profile has been demonstrated with pollen and house dust mite (HDM) allergens in the treatment of airway allergies. In addition, the use of grass pollen presents a SLIT disease-modifying treatment for respiratory allergies. OBJE...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000446155
更新日期:2016-01-01 00:00:00
abstract::Peritoneal mast cells of Syrian hamsters release histamine to the action of concanavalin A (Con A) in dose-dependent fashion. The rate of release was very rapid in the first seconds of cell activation and completed in 60 s after the challenge. Morphological changes concomitant to the lectin treatment, followed by elec...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000236113
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:The prevalence of allergic rhinitis (AR) is increasing rapidly in Central China. The skin prick test (SPT) is the standard tool with which to determine the allergen sensitization status in AR patients. Changes in allergen sensitization patterns have been observed within countries and regions due to geographi...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000479429
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:15-Deoxy-Delta(12,14)-prostaglandin J2 (15d-PGJ2), a major prostanoid metabolized from prostaglandin D2 (PGD2), plays an important role in various biological processes including inflammatory responses. 15d-PGJ2 exerts its effects through two major receptors, chemoattractant receptor- homologous molecule expr...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000211377
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Although common variable immunodeficiency (CVID) is associated with sinopulmonary disease, there are no previous systematic evaluations comparing computed tomographic (CT) sinus imaging with immunoglobulin measurements in patients with this condition. METHODS:We performed a retrospective review by a blinded...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000260088
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Mugwort (Artemisia vulgaris) represents an important source of weed pollen allergens. The objectives of the present study were (i) to analyze the IgE binding profiles in a group of mugwort-allergic patients, (ii) to identify individual marker allergens crucial for the diagnosis of mugwort allergy and (iii) t...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000108134
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Cytosolic phospholipase A2 (cPLA2) plays a key role in the development of late-phase anaphylaxis. L-Glutamine (Gln), a nonessential amino acid, has anti-inflammatory activity via inhibiting cPLA2. METHODS:We used a penicillin-induced murine model of anaphylaxis, and late-phase anaphylaxis was quantified by ...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000452103
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Epidemiological data on food allergy are scarce in African countries. We studied the prevalence of food sensitization in Ghanaian schoolchildren. METHODS:Children (5-16 years; n = 1,714) from 9 Ghanaian schools were given parental consent to participate in the study. Adverse reactions and food consumption w...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000318704
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:To understand how the high-affinity IgE receptor (FcepsilonRI) communicates with downstream effectors, we focused on exploring the functional importance of the FcepsilonRI-mediated formation and localization of a signaling complex that contains the hematopoietic cell-specific scaffolding protein linker for a...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章,评审
doi:10.1159/000053692
更新日期:2001-01-01 00:00:00
abstract::In the present study, we investigated the role of resident peritoneal cells as well as the mediators involved in the eosinophil migration induced by large volumes of physiological saline. Two consecutive intraperitoneal injections of saline given 48 h apart, induced a selective recruitment of eosinophils into the cavi...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000236687
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Galectin-9 was recently identified as a ligand for Tim-3, which negatively regulates Th1 cells. Here, we investigated whether administration of anti-galectin-9 antibodies (Abs) affects the development of murine experimental allergic conjunctivitis (EC), a Th2-mediated disease. METHODS:EC was induced in BALB...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000112501
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:In some subjects, specific foods trigger anaphylaxis when exercise follows ingestion (specific food-dependent exercise-induced anaphylaxis, FDEIAn). Skin test and/or RAST positivity to foods suggest an IgE-mediated pathogenic mechanism. Others suffer from anaphylaxis after all meals followed by exercise, reg...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000053825
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:High antibiotic prescribing rates for adults with an asthma exacerbation have been reported in developed countries, but few studies have assessed the variation of antibiotic and adjunctive treatment in the routine care of children. OBJECTIVE:We evaluated the trends in health resource utilization for childre...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000507857
更新日期:2020-01-01 00:00:00
abstract::Phosphoinositide 3-kinases (PI3Ks) are known to be involved in a variety of cellular responses such as cell survival, proliferation, differentiation and cell migration. Recently, PI3Ks have been associated with the pathogenesis of asthma because various immune cells regulate allergic responses. Among the three classes...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章,评审
doi:10.1159/000312132
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:While searching for antigliadin and anticasein antibodies in sera from coeliac patients we investigated more than 20 persons suffering from this enteropathy. In some of sera, we registered antibodies against gliadin and in parallel the appearance of anticasein antibodies. A high percentage of glutamic acid h...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000024003
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:It is important to understand that allergic rhinitis, whether seasonal or perennial, may be difficult to distinguish clinically from the nonallergic forms of rhinitis. OBJECTIVE:This study aimed to investigate the presence of local allergic rhinitis (LAR) in children who have allergic rhinitis symptoms in t...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000447635
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Hymenoptera venom allergy (HVA) has a prevalence of 3% in adults. Although patients have no ongoing symptoms, they often suffer from an impairment of their psychological well-being and quality of life. OBJECTIVE:The aim of this study was to analyze sex-specific differences regarding the psychological burden...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000507625
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Numerous strategies have been proposed for the treatment of peanut allergies, but despite the steady advancement in our understanding of atopic immune responses and the increasing number of deaths each year from peanut anaphylaxis, there is still no safe, effective, specific therapy for the peanut-sensitive ...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000053672
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Subcutaneous immunotherapy for respiratory allergy has shown a long lasting efficacy after its discontinuation, whereas evidence in the case of sublingual immunotherapy (SLIT) is weak. This retrospective study evaluates whether SLIT exerts a long-lasting effect and whether it relates to its duration. METHOD...
journal_title:International archives of allergy and immunology
pub_type: 临床试验,杂志文章
doi:10.1159/000096001
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Cross-reactivity between aztreonam and β-lactams is poor, but tolerability of aztreonam has been assessed in a few groups of patients suffering from IgE-mediated allergy to β-lactams. The aim of this study was to assess the cross-reactivity of aztreonam with other β-lactams and its tolerability in patients w...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000318844
更新日期:2011-01-01 00:00:00
abstract::Red soft coral (RSC; Dendronephthya nipponica, a marine coelenterate) causes spiny lobster fishermen living along the Pacific coast of Miyazaki Prefecture in Japan to develop occupational allergies, such as conjunctivitis, rhinitis, dermatitis and bronchial asthma. The aim of this study was to purify and to characteri...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000053807
更新日期:2001-06-01 00:00:00
abstract::The allergic pig can be used as a large-animal model for studies of allergic reactions in the airways and the role of eosinophils in such reactions. To measure the activation of eosinophils, the release of eosinophil-derived cationic proteins can be used. The purpose of this study was to isolate and characterize catio...
journal_title:International archives of allergy and immunology
pub_type: 杂志文章
doi:10.1159/000237277
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Proton pump inhibitors (PPIs) can trigger immediate-type hypersensitivity reactions (HSRs). Three main patterns of cross-reactivity have been identified: reactions to a single PPI, selective cross-reactions, and cross-reactions with all PPIs. Several hypotheses have been advanced, but no consensus has been r...
journal_title:International archives of allergy and immunology
pub_type:
doi:10.1159/000493581
更新日期:2019-01-01 00:00:00