Figure 5 depicts the results of a meta-analysis for the comparison of oral selective antihistamine versus intranasal corticosteroid. Three trials reported on the outcome of congestion at four weeks. A random effects model using inverse variance weighting was used. Standardized mean differences are reported for individual trials and for the overall pooled effect. In the first trial, Bernstein, 2004, there were 158 patients in the oral selective antihistamine group and 158 patients in the intranasal corticosteroid group. The mean difference was 0.43 favoring intranasal corticosteroid with a 95 percent confidence interval of 0.21 to 0.65. The weight of this trial was 33.7 percent. In the second trial, Condemi, 2000, there were 174 patients in the oral selective antihistamine group and 174 patients in the intranasal corticosteroid group. The mean difference was 0.31 favoring intranasal corticosteroid with a 95 percent confidence interval of 0.10 to 0.53. The weight of this trial was 35.8 percent. In the third trial, Schoenwetter, 1995, there were 140 patients in the oral selective antihistamine group and 134 patients in the intranasal corticosteroid group. The mean difference was 0.62 favoring intranasal corticosteroid with a 95 percent confidence interval of 0.37 to 0.86. The weight of this trial was 30.4 percent. The overall result included 472 patients in the oral selective antihistamine group and 466 patients in the intranasal corticosteroid group. The overall pooled mean difference was 0.45 favoring intranasal corticosteroid with a 95 percent confidence interval of 0.28 to 0.61. The figure shows a forest plot of these results. The x-axis spans minus 1 at the left favoring oral selective antihistamine to positive 1 at the right favoring intranasal corticosteroid. There is a vertical line at zero that that extends up from the x-axis. The standardized mean difference for each trial is represented by a green box sized according to the weight of the trial. The confidence interval is represented by a horizontal black line centered on the box. The overall pooled result is represented by a black diamond, the ends of which represent the confidence interval for the pooled result. The green boxes for each trial and the black diamond for the pooled result all fall to the right of the vertical line. Tests for heterogeneity are Tau squared of 0.01, chi squared of 3.37 with 2 degrees of freedom and a p-value of 0.19, and I squared of 41 percent. The Z test for overall effect was 5.17 with a p-value less than 0.00001.

Figure 5Congestion at 4 weeks: meta-analysis of 3 trials–oral selective antihistamine versus intranasal corticosteroid

From: Results

Cover of Treatments for Seasonal Allergic Rhinitis
Treatments for Seasonal Allergic Rhinitis [Internet].
Comparative Effectiveness Reviews, No. 120.
Glacy J, Putnam K, Godfrey S, et al.

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