Efficacy and safety of monotherapy versus combination therapy in treatment of allergic rhinitis : a Meta-analysis

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Objective:To evaluate efficacy and safety of monotherapy versus combination therapy on allergic rhinitis（AR） in order to provide evidencebased reference for clinic drug treatment of AR.Method:The randomized controlled trials（RCT） about drug treatment of AR were searched in PubMed, Embase, Cochrane library, CNKI, WanFang Data. After screening the literatures, extracting the data and evaluating the quality, to compare total nasal symptom scores（TNSS）,composite symptom scores（CSS）,daytime nasal symptom scores（DNSS）,individual nasal symptom scores, total ocular symptom scores（TOSS）, daytime eye symptom scores（DESS）and incidence of adverse events（AE）between monotherapy group and combination therapy group. Meta-analysis was performed by RevMan 5.3 software.Result:A total of 12 RCTs were enrolled, 7 675 AR patients involved. The results of Metaanalysis showed that the efficacy of combination therapy group was superior to the monotherapy group in TNSS with significant difference（WMD=0.74,95%CI 0.31-1.17,P<0.05;WMD=1.40,95%CI0.98-1.82,P<0.05）.Compared with monotherapy group, individual nasal symptom scores in combination group were significantly decreased. There were no significant difference in incidence of AE（headache, dysgeusia, epistaxis） between two groups（RR=1.20,95%CI 0.87-1.65, P=0.28;RR=0.63,95%CI 0.31-1.24,P=0.18;RR=0.96,95%CI 0.63-1.64, P=0.85.Conclusion:Combination therapy can remarkably improve nasal symptom in AR patients compared with monotherapy, moreover, the incidence of AE between two groups were similar. We recommend combination therapy for allergic rhinitis.