Efficiency and safety of desloratadine in combination with compound glycyrrhizin in the treatment of chronic urticaria: a meta-analysis and systematic review of randomised controlled trials

Abstract

Context

Desloratadine, an H1 receptor antagonist, is suggested as an effective first-line drug for chronic urticarial (CU). However, the efficacy of desloratadine alone is limited, and the recurrence rate of CU is relatively high.

Objective

We sought to evaluate the efficacy and clinical feasibility of desloratadine in combination with compound glycyrrhizin in the treatment of CU.

Materials and methods

A systematic literature search was conducted in the databases of the China National Knowledge Infrastructure Database, VIP, WanFang, PubMed, and Web of Science using subject terms: “Chronic urticaria”, “Loratadine”, and “Compound glycyrrhizin”. Randomised controlled trials (RCTs) that compared the efficiency and safety of the combination treatment with desloratadine alone starting from January 1, 2014 until February 10, 2021 were selected by two co-first authors independently, and the extracted data were analysed using Rev Man 5.3 software.

Results

Fourteen RCTs were included in our meta-analysis with a total of 1501 patients. The results showed that the combination treatment yielded a better treatment effect (total response rate: RR = 1.23, 95% CI: 1.17 to 1.29, p < 0.00001; cure rate: RR = 1.50, 95% CI: 1.30 to 1.73, p < 0.00001), lower recurrence rate as well as superior immune improvement than the treatment with desloratadine alone. In addition, there was no significant difference in the safety of the two treatments.

Discussion and Conclusion

The combination of desloratadine and compound glycyrrhizin is a promising treatment for CU and is associated with decreased serum IgE level and improved proportions of CD4+ T and CD8+ T cells.

Keywords:

• Immune regulation
• loratadine

Author contributions

YW and YT reviewed and drafted the manuscript, and they contributed equally to this work as co-first authors. YW and YT independently performed literature searches, and ML reviewed the results of the selected literature. YT and ML conducted data extraction and quality assessment. YW and YT performed the analyses with LM. YW and YT wrote the initial draft. YL critically revised the paper. All authors contributed to manuscript revision and read and approved the submitted version.

Disclosure statement

The authors declare that there are no conflicts of interest regarding the publication of this article.

Additional information

Funding

This research was supported by the Xinglin Scholar Research Promotion Project of Chengdu University of TCM [grant number XSGG2020001]. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.