Comparing four immunosuppressive agents for chronic spontaneous urticaria-A network meta-analysis.
Humans
Immunosuppressive Agents
/ therapeutic use
Cyclosporine
/ therapeutic use
Methotrexate
/ therapeutic use
Azathioprine
/ therapeutic use
Network Meta-Analysis
Chronic Disease
Chronic Urticaria
/ chemically induced
Histamine H1 Antagonists
/ therapeutic use
Urticaria
/ drug therapy
Histamine Antagonists
Drug-Related Side Effects and Adverse Reactions
/ drug therapy
Glycosides
/ therapeutic use
Treatment Outcome
Omalizumab
/ therapeutic use
Anti-Allergic Agents
/ therapeutic use
Randomized Controlled Trials as Topic
Chronic spontaneous urticaria
Immunosuppressant
Network meta-analysis
UAS7
Journal
International immunopharmacology
ISSN: 1878-1705
Titre abrégé: Int Immunopharmacol
Pays: Netherlands
ID NLM: 100965259
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
16
04
2023
revised:
23
06
2023
accepted:
23
06
2023
medline:
22
9
2023
pubmed:
12
8
2023
entrez:
11
8
2023
Statut:
ppublish
Résumé
Immunosuppression is an integral part of treating chronic spontaneous urticaria (CSU), but there is no literature to evaluate the efficacy of multiple immunosuppressive agents. The comparison of the efficacy, safety, and incidence of adverse effects of four immunosuppressive medicines (tripterygium glycosides, methotrexate, cyclosporine A, and azathioprine) in combination with antihistamines in treating CSU provides a clinical reference and evidence-based medicine for treating CSU. PUBMED, The Cochrane Library, EMBASE, WANFANG, CNKI, CBM, and clinical trial registration platform were searched to collect relevant randomized controlled trials (RCT) and cohort studies of four immunosuppressive medicines combined with antihistamines for treating CSU. The primary outcomes were the efficacy of weekly urticaria activity score 7 (UAS7) and adverse effects. This study pooled data from seven randomized clinical trials with 410 participants. The standardized mean differences for change in UAS7 were 0.10 (95% confidence interval (CI), 0.01 to 0.68) for cyclosporine A plus antihistamine; 0.03 (95% CI, 0.00 to 0.23) for azathioprine plus antihistamine; 0.52 (95% CI, 0.32 to 0.85) for tripterygium glycosides plus antihistamine; and 1.54 (95% CI, 0.64 to 3.67) for methotrexate plus antihistamine. There were no significant differences in side effects between these medicines in the limited number of trials and clinical samples. Our results indicate that cyclosporine A combined with antihistamine resulted in greater improvements regarding the UAS7 in CSU patients and that tripterygium glycosides are also effective in treating CSU.
Sections du résumé
BACKGROUND
BACKGROUND
Immunosuppression is an integral part of treating chronic spontaneous urticaria (CSU), but there is no literature to evaluate the efficacy of multiple immunosuppressive agents.
OBJECTIVE
OBJECTIVE
The comparison of the efficacy, safety, and incidence of adverse effects of four immunosuppressive medicines (tripterygium glycosides, methotrexate, cyclosporine A, and azathioprine) in combination with antihistamines in treating CSU provides a clinical reference and evidence-based medicine for treating CSU.
METHODS
METHODS
PUBMED, The Cochrane Library, EMBASE, WANFANG, CNKI, CBM, and clinical trial registration platform were searched to collect relevant randomized controlled trials (RCT) and cohort studies of four immunosuppressive medicines combined with antihistamines for treating CSU. The primary outcomes were the efficacy of weekly urticaria activity score 7 (UAS7) and adverse effects.
RESULTS
RESULTS
This study pooled data from seven randomized clinical trials with 410 participants. The standardized mean differences for change in UAS7 were 0.10 (95% confidence interval (CI), 0.01 to 0.68) for cyclosporine A plus antihistamine; 0.03 (95% CI, 0.00 to 0.23) for azathioprine plus antihistamine; 0.52 (95% CI, 0.32 to 0.85) for tripterygium glycosides plus antihistamine; and 1.54 (95% CI, 0.64 to 3.67) for methotrexate plus antihistamine. There were no significant differences in side effects between these medicines in the limited number of trials and clinical samples.
CONCLUSION
CONCLUSIONS
Our results indicate that cyclosporine A combined with antihistamine resulted in greater improvements regarding the UAS7 in CSU patients and that tripterygium glycosides are also effective in treating CSU.
Identifiants
pubmed: 37567010
pii: S1567-5769(23)00903-7
doi: 10.1016/j.intimp.2023.110577
pii:
doi:
Substances chimiques
Immunosuppressive Agents
0
Cyclosporine
83HN0GTJ6D
Methotrexate
YL5FZ2Y5U1
Azathioprine
MRK240IY2L
Histamine H1 Antagonists
0
Histamine Antagonists
0
Glycosides
0
Omalizumab
2P471X1Z11
Anti-Allergic Agents
0
Types de publication
Meta-Analysis
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
110577Informations de copyright
Copyright © 2023. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.