Approximately individual fifth of ...

Approximately individual fifth of the population in the United Kingdom endures from seasonal allergic conjunctivitis. Symptoms of ocular irritation, rednes and tearing (frequently accompanied according to nasal symptoms) typically occur during pollen- producing seasons. As the underlying mechanism of this condition is believed to be a mark 1, IgE-mediated hypersensitivity, topical mast small cavity stabilizers and antihistamines are used to hinder symptoms. Systemic antihistamines may be prescribed for patients with more widespread symptoms, and steroids are used occasionally in stern cases. Owen and colleagues con-duct a systematic review to determine the relative effectiveness of topical mast confined apartment stabilizers and antihistamines in symptomatic therapy for seasonal allergic conjunctivitis.

Electronic databases, including the Cochrane Library, and bibliographies of relevant articles were used to identify clinical trials comparing topical mast enclosed space stabilizers or antihistamines with placebo, and these sum of two units classes of agents with the same another. Of the 140 original studies identified, 40 met quality criteria for inclusion in the meta-analysis.

Placebo-controlled trials of the mast small room stabilizers sodium cromoglycate, nedocromil, and lodoxamide were identified. The 17 studies of sodium cromoglycate minded to involve small numbers of patients, differed in issue measures, and showed evidence of publication bias. Nevertheless, the authors calculate a significant difference in perceived benefit across placebo with no important side drifts Patients also perceived significant improvement in symptoms in three of the five trials of topical nedocromil. The authors calculate that patients treated with this unsalable article were 1.8 times more likely to report moderate or full control of symptoms than patients given the placebo. A significant benefit also was reported for topical lodoxamide compared with placebo, if it be not that this was based on single in kind small study. In the lakeed analysis of the 12 topical mast confined apartment stabilizer studies, patients were 49 times more likely to report symptom relief compared with placebo.

Nine studies comparing topical antihistamines with placebo were identified. Six of these studies used levocabastine, and the remaining studies involved azelastine, emedastine, and antazoline. most numerous studies used subjective symptom scales complet by dint of patients after provocation, and springs showed symptom improvement, especially in itching. A formal meta- analysis was not possible because of subject of attention designs.

Eight trials compared the effectiveness of topical mast confined apartment stabilizers with topical antihistamine. A formal meta- analysis was not possible because of differences in the reporting of results The topical antihistamine appeared to attenuate symptoms better than mast lonely dwelling stabilizers in short-term provocation studies and showed limited evidence of a faster charge of action. Otherwise, no significant differences were apparent between the classes of medication.

The authors decide that topical mast cell stabilizers and antihistamines provide significantly better symptom relief than placebo in allergic conjunctivitis. Based in succession available evidence, the choice of a specific agent should be determined by the agency of factors such as convenience of use, take away from and patient preferences.

Owen CG et al. Topical treatments for seasonal allergic conjunctivitis: systematic review and meta-analysis of efficacy and effectiveness. Br J Gen Pract June 2004;54:451-6

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