Prednisolone versus antihistamine for allergic rhinitis: No significant difference found in randomized trial

Area of Science:

• Allergy and Immunology
• Pharmacology
• Clinical Medicine

Background:

• Seasonal allergic rhinitis (AR) significantly impacts public health, affecting quality of life and productivity.
• The Swedish tree pollen season spans from February to May, with various pollens.
• Systemic corticosteroids are often used for AR when topical treatments fail, despite limited evidence.

Purpose of the Study:

• To compare the efficacy of prednisolone tablets versus antihistamine tablets in managing moderate to severe tree pollen-induced AR.
• To assess symptom reduction and medication usage in patients with AR.

Main Methods:

• A double-blinded randomized trial involving 34 patients with tree pollen-induced AR.
• Patients received either prednisolone (20 mg) or ebastine (20 mg) tablets for 7 days.
• Daily symptom scores, topical medication use, and quality of life were evaluated.

Main Results:

• Both prednisolone and ebastine treatments improved quality of life metrics.
• No statistically significant difference was found in the combined symptom severity and medication usage scores between the groups (p=0.80).
• Adverse events were mild and comparable in frequency and severity between the treatment groups.

Conclusions:

• Prednisolone tablets did not demonstrate superior efficacy compared to antihistamine tablets for tree pollen-induced AR.
• Systemic corticosteroids may not offer additional benefits over antihistamines for AR.
• Treatment decisions should prioritize patient preferences and tolerability for individualized care.