UASSIGNED:过敏性疾病的全球流行对大量儿童的健康和生活产生了负面和广泛的影响。这项研究调查了疗效,可接受性,西替利嗪(CTZ)治疗儿童过敏性疾病的安全性,并为决策提供循证断言。
未经授权:PubMed,Embase,Cochrane图书馆,世界卫生组织国际临床试验注册平台,ClinicalTrials.gov,和欧盟临床试验注册从开始到2022年4月21日进行了系统检索.纳入了接受CTZ的过敏性疾病儿童与接受安慰剂或其他药物的儿童相比的随机对照试验(RCTs)或准RCTs,而没有语言限制。两名调查人员独立鉴定了文章,提取的数据,进行了荟萃分析,评估了个别研究的Cochrane偏倚风险,并使用建议等级评估来评估证据的确定性,发展,和评估方法;任何差异都通过与第三位研究者协商解决。主要结果包括评估AR过敏状况恢复的量表,如总症状评分(TSS)。次要结果包括实验室测试变化,安全性(不良事件,AE),和生活质量(QOL)。使用CochraneReviewManager5.4汇总数据,如果异质性被评估为低(I2<50%),则使用固定效应模型;否则,采用随机效应模型。
未经评估:最终纳入了22项研究(5,867例患者)[8例患有常年性AR,六个带有季节性AR,四例特应性皮炎(AD),和四个患有其他过敏性疾病],其中大多数偏倚风险较低或不明确.中度确定性证据表明,发现CTZ对过敏症状控制有益[1周时TSS的平均差(MD):MD,-0.32(-0.52,-0.12);2周时:MD,-0.25(-0.35,-0.14);4周时:MD,-4.07(-4.71,-3.43);在8周时:MD,-4.22(-4.73,-3.72);12周时:MD,-5.63(-6.14,-5.13);所有P值均小于0.05]和QOL[在12周时:MD,-23.16(-26.92,-19.39);P<0.00001]儿童AR。与其他抗组胺药(AHs)或孟鲁司特相比,其疗效相似,在儿童中没有表现出更好的AD严重程度控制。中度至低度确定性证据表明,CTZ耐受性良好,不会增加严重和总体不良事件的风险。心脏毒性,对中枢神经和消化系统的损害,或其他儿童系统,除了嗜睡的风险[风险比,1.62(1.02,2.57);与安慰剂相比,P=0.04]。
UNASSIGNED:中等至低确定性证据表明,CTZ可以改善AR患儿的临床改善和生活质量,并且与其他AHs具有相当的疗效。CTZ在儿科人群中耐受性良好,除了嗜睡风险增加.
UNASSIGNED:[https://www.crd.约克。AC.uk/PROSPERO/],标识符[CRD42021262767]。
UNASSIGNED: The global prevalence of allergic diseases has led to a negative and extensive impact on the health and lives of a large population of children. This study investigates the efficacy, acceptability, and safety of
cetirizine (CTZ) for treating allergic diseases in children and provides evidence-based assertions for decision-making.
UNASSIGNED: PubMed, Embase, the Cochrane Library, World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, and the European Union Clinical Trials Register were systematically searched from inception to April 21, 2022. Randomized controlled trials (RCTs) or quasi-RCTs of children with allergic diseases receiving CTZ compared with those receiving placebo or other drugs were included without language limitations. Two investigators independently identified articles, extracted data, conducted meta-analyses, assessed the Cochrane risk of bias of individual studies, and evaluated the evidence certainty using the Grading of Recommendations Assessment, Development, and Evaluation approach; any discrepancies were resolved by consulting with a third investigator. Primary outcomes included scales that evaluated the recovery of allergic conditions in AR, such as the total symptom score (TSS). Secondary outcomes included laboratory test changes, safety (adverse events, AEs), and quality of life (QOL). Data were pooled using the Cochrane Review Manager 5.4, and a fixed-effects model was used if heterogeneity was evaluated as low (I 2 < 50%); otherwise, a random-effects model was adopted.
UNASSIGNED: A total of 22 studies (5,867 patients) were ultimately included [eight with perennial AR, six with seasonal AR, four with atopic dermatitis (AD), and four with other allergic diseases], most of which had a low or unclear risk of bias. Moderate certainty evidence showed that CTZ was found to benefit allergic symptom control [mean difference (MD) of TSS at 1 week: MD, -0.32 (-0.52, -0.12); at 2 weeks: MD, -0.25 (-0.35, -0.14); at 4 weeks: MD, -4.07 (-4.71, -3.43); at 8 weeks: MD, -4.22 (-4.73, -3.72); at 12 weeks: MD, -5.63 (-6.14, -5.13); all P-values were less than 0.05] and QOL [at 12 weeks: MD, -23.16 (-26.92, -19.39); P < 0.00001] in children with AR. It had similar efficacy compared with other antihistamines (AHs) or montelukast, without showing better control of AD severity in children. Moderate-to-low certainty evidence demonstrated that CTZ was well tolerated and did not increase the risk of severe and overall AEs, cardiotoxicity, damage to the central nervous and digestive systems, or other systems in children, except for the risk of somnolence [risk ratio, 1.62 (1.02, 2.57); P = 0.04, compared with placebo].
UNASSIGNED: Moderate-to-low certainty evidence revealed that CTZ could improve clinical improvement and QOL in children with AR and have comparable efficacy with other AHs. CTZ is well tolerated in the pediatric population, except for an increased risk of somnolence.
UNASSIGNED: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021262767].