Prednisolone versus antihistamine for allergic rhinitis : No significant difference found in randomized trial
(2025) In Clinical and Translational Allergy 15(1).- Abstract
Background: Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy. Objective: To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR. Methods: This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen... (More)
Background: Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy. Objective: To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR. Methods: This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen season. The two groups received either prednisolone tablets (20 mg) or ebastine tablets (20 mg) for 7 days. Treatment effects were evaluated by comparing daily symptom scores, use of topical medication, and a combined symptom-medical score between the groups. Quality of life was recorded at the start and after 3 weeks. Results: Both interventions demonstrated efficacy in enhancing quality of life metrics. The area under the curve (AUC) for the combined symptom severity and medication usage score averaged 34.0 (SD = 19.1, 95% CI = 24.5–43.4) in the group treated with prednisolone. This was marginally lower than the control group, with an AUC of 32.6 (SD = 13.2, 95% CI = 25.6–39.7). The difference was not statistically significant (p = 0.80). Both groups exhibited only mild adverse events, which were statistically comparable in frequency and severity. Conclusions: Prednisolone tablets did not show superior efficacy over antihistamine tablets in reducing symptoms or medication usage in tree pollen-induced AR. These results suggest that systemic corticosteroids may not provide additional benefits over antihistamines, and clinicians should prioritize individualized treatment based on patient preferences and tolerability.
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- author
- Skröder, Carl LU ; Hellkvist, Laila ; Westin, Ulla LU ; Sahlstrand-Johnsson, Pernilla ; Hansson, Kerstin LU ; Karlsson, Agneta ; Dahl, Åslög ; Bjermer, Leif LU and Cardell, Lars Olaf LU
- organization
- publishing date
- 2025-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- allergic rhinitis, antihistamines prednisolone, randomized trial, treatment efficacy
- in
- Clinical and Translational Allergy
- volume
- 15
- issue
- 1
- article number
- e70017
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:39788913
- scopus:85214658208
- ISSN
- 2045-7022
- DOI
- 10.1002/clt2.70017
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 The Author(s). Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.
- id
- e5f7a1c9-89ae-4cbf-bf12-6e7c2a1c6d11
- date added to LUP
- 2025-03-24 14:04:01
- date last changed
- 2025-07-14 20:44:38
@article{e5f7a1c9-89ae-4cbf-bf12-6e7c2a1c6d11,
abstract = {{<p>Background: Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy. Objective: To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR. Methods: This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen season. The two groups received either prednisolone tablets (20 mg) or ebastine tablets (20 mg) for 7 days. Treatment effects were evaluated by comparing daily symptom scores, use of topical medication, and a combined symptom-medical score between the groups. Quality of life was recorded at the start and after 3 weeks. Results: Both interventions demonstrated efficacy in enhancing quality of life metrics. The area under the curve (AUC) for the combined symptom severity and medication usage score averaged 34.0 (SD = 19.1, 95% CI = 24.5–43.4) in the group treated with prednisolone. This was marginally lower than the control group, with an AUC of 32.6 (SD = 13.2, 95% CI = 25.6–39.7). The difference was not statistically significant (p = 0.80). Both groups exhibited only mild adverse events, which were statistically comparable in frequency and severity. Conclusions: Prednisolone tablets did not show superior efficacy over antihistamine tablets in reducing symptoms or medication usage in tree pollen-induced AR. These results suggest that systemic corticosteroids may not provide additional benefits over antihistamines, and clinicians should prioritize individualized treatment based on patient preferences and tolerability.</p>}},
author = {{Skröder, Carl and Hellkvist, Laila and Westin, Ulla and Sahlstrand-Johnsson, Pernilla and Hansson, Kerstin and Karlsson, Agneta and Dahl, Åslög and Bjermer, Leif and Cardell, Lars Olaf}},
issn = {{2045-7022}},
keywords = {{allergic rhinitis; antihistamines prednisolone; randomized trial; treatment efficacy}},
language = {{eng}},
number = {{1}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Clinical and Translational Allergy}},
title = {{Prednisolone versus antihistamine for allergic rhinitis : No significant difference found in randomized trial}},
url = {{http://dx.doi.org/10.1002/clt2.70017}},
doi = {{10.1002/clt2.70017}},
volume = {{15}},
year = {{2025}},
}