Hackensack Meridian School of Medicine at Seton Hall University, Departments of Medicine and Ophthalmology, Nutley, New Jersey.
Dallas Allergy and Asthma Center, Dallas, Texas.
Ann Allergy Asthma Immunol. 2020 Jun;124(6):616-621.e3. doi: 10.1016/j.anai.2020.01.012. Epub 2020 Jan 28.
Allergic rhinitis is a prevalent disease, which can be classed as seasonal (SAR) or perennial. In addition to nasal symptoms, up to 75% of sufferers experience itching, redness, and tearing of the eyes. Intranasal corticosteroids are effective in controlling the allergic nasal symptoms, and increasing evidence suggests that they also can relieve some of the allergic ocular symptoms.
To evaluate the magnitude of efficacy of triamcinolone acetonide (TAA) compared with placebo or fluticasone propionate (FP) on ocular symptom improvement in patients with SAR.
A meta-analysis of summary data from 8 randomized, double- or single-blind trials, assessing mean change in total or individual (tearing, redness, and itching) eye symptoms was conducted. Trials that administered a daily dose of 220 μg TAA vs placebo or 200 μg FP over at least 2 weeks' duration, in patients aged 12 years or older with SAR, were analyzed.
Total eye symptom reduction after 2 weeks was greater with TAA than placebo, with a mean treatment difference of -0.32 (95% CI, -0.444 to -0.203). In addition, significant reductions in tearing, but not itching or redness, were observed after TAA treatment compared with placebo. No significant treatment difference was seen between TAA and FP in total ocular symptoms at any of the time points measured (weeks 1, 2, 3, and overall). All treatments exhibited similar safety profiles and were deemed well tolerated.
The meta-analysis demonstrated the positive clinical improvements TAA has on total ocular allergy symptoms, especially tearing, in addition to its recognized nasal symptom efficacy in SAR.
过敏性鼻炎是一种常见疾病，可分为季节性（SAR）或常年性。除了鼻部症状外，多达 75%的患者会出现眼睛瘙痒、发红和流泪。鼻内皮质类固醇可有效控制过敏性鼻部症状，越来越多的证据表明它们还可以缓解一些过敏性眼部症状。
评估曲安奈德（TAA）与安慰剂或丙酸氟替卡松（FP）相比，在改善 SAR 患者眼部症状方面的疗效。
对 8 项随机、双盲或单盲试验的汇总数据进行荟萃分析，评估总眼部症状或单个症状（流泪、发红和瘙痒）的平均变化。分析了每天给予 220 μg TAA 与安慰剂或 200 μg FP 治疗至少 2 周的年龄在 12 岁或以上 SAR 患者的试验。
与安慰剂相比，TAA 治疗 2 周后总眼部症状减轻更明显，平均治疗差异为-0.32（95%CI，-0.444 至-0.203）。此外，与安慰剂相比，TAA 治疗后流泪显著减少，但瘙痒或发红无显著减少。在所有测量的时间点（第 1、2、3 周和总体），TAA 与 FP 在总眼部症状方面均未显示出显著的治疗差异。所有治疗均具有相似的安全性，且耐受性良好。
荟萃分析表明，TAA 除了对 SAR 具有公认的鼻部症状疗效外，还对总眼部过敏症状，特别是流泪具有积极的临床改善作用。
