Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25 Kynsey Road, Colombo 08, Sri Lanka.
Department of Pharmacology, Faculty of Medicine, Colombo, Sri Lanka.
Allergy Asthma Clin Immunol. 2014 May 7;10(1):24. doi: 10.1186/1710-1492-10-24. eCollection 2014.
A significant proportion of patients with chronic urticaria respond inadequately to first line treatment with antihistamines. Leukotreine receptor antagonists (LTRA) are also used for chronic urticaria, although firm recommendations on their use are lacking. We performed a systematic review of randomised trials to determine the role of LTRA in treatment of chronic urticaria. A search of PUBMED, EMBASE, SCOPUS, LILACS, the Cochrane Central Register of Controlled Trials, and the Web of Science for relevant randomized control trials or cross over studies yielded 10 eligible studies. The heterogeneity of trials were high, preventing valid meta-analysis of data. Most trials indicated that LTRA are not superior to placebo or antihistamine therapy, while combination therapy of LTRA and antihistamines appear to be more efficacious compared to antihistamine alone. The side effect profile and tolerability of this group of drugs is acceptable. The use of LTRA as monotherapy cannot be recommended. LTRA are effective add-on therapy to anti-histamines, and their use in patients responding poorly to antihistamines is justifiable. Further well designed randomized controlled trials with clear and standardized outcome measures are needed to determine the role of LTRA in chronic urticaria.
相当一部分慢性荨麻疹患者对一线抗组胺治疗反应不佳。白三烯受体拮抗剂（LTRA）也用于慢性荨麻疹，尽管缺乏其使用的明确建议。我们对随机试验进行了系统评价，以确定 LTRA 在慢性荨麻疹治疗中的作用。在 PUBMED、EMBASE、SCOPUS、LILACS、Cochrane 对照试验中心注册库和 Web of Science 中搜索相关的随机对照试验或交叉研究，共获得 10 项合格的研究。试验的异质性很高，无法对数据进行有效的荟萃分析。大多数试验表明，LTRA 并不优于安慰剂或抗组胺治疗，而 LTRA 与抗组胺药联合治疗似乎比单独使用抗组胺药更有效。该类药物的副作用谱和耐受性是可以接受的。不能推荐 LTRA 作为单一疗法。LTRA 是抗组胺药的有效附加治疗，在对抗组胺药反应不佳的患者中使用是合理的。需要进一步设计良好的随机对照试验，采用明确和标准化的结局指标，以确定 LTRA 在慢性荨麻疹中的作用。
