アレルギー性鼻炎に対する口服抗ヒスタミンの有効性と安全性:ネットワークメタ解析
Rafael José Vieira1, Sara Gil-Mata1, André Ferreira2
1MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal.
The journal of allergy and clinical immunology. In practice
|February 18, 2026
まとめ
口服用H1抗ヒスタミン (OAH) は,アレルギー性鼻炎 (AR) の緩和をもたらす. いくつかのOAHはわずかに優れた有効性を示していますが,ほとんどの第二世代のオプションは,同様の安全性プロファイルと有効性のわずかな違いがあります.
科学分野:
- 薬理学 薬理学とは
- クリニカル・メディシン 臨床医学
- 根拠に基づいた医学は,証拠に基づいた医療です.
背景:
- 口服H1抗ヒスタミン剤 (OAH) は,アレルギー性鼻炎 (AR) に対して頻繁に処方されています.
- 異なるOAHの比較効果と安全性を評価することは,臨床意思決定において極めて重要です.
研究 の 目的:
- 体系的なレビューとネットワークのメタ分析を行う.
- AR患者における個々のOAHの有効性と安全性を比較する.
主な方法:
- OAHとプラセボまたは個々のOAHを比較するランダム化比較試験 (RCT) を複数のデータベースで検索しました.
- 症状のスコア,生活の質,有害事象に関するネットワークメタ分析を実施しました.
- 第2世代のOAHに対するGRADE-NMAを用いた証拠の確実性の評価.
主要な成果:
- 74件のRCT (21件の常年RA,53件の季節RA) を含む.
- セチリジン,エバスティン,ビラスティン,ルパタディンは鼻の症状に対して高い有効性を示したが,他の結果は異なる.
- 第二世代のOAHでは,有害事象の発生率が類似しており,重篤な事象はまれでした.
- 証拠の確実性は一般的に低いか非常に低いものでした.
結論:
- 一部のOAHはより効果的かもしれませんが,第2世代の薬との違いはしばしば些細です.
- 第2世代のOAHでは,安全性プロフィールにおいて有意な差異は認められなかった.
- 証拠の確実性が低いため,治療効果に関してかなりの不確実性が存在します.
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