[Summary text]
Skal glucocorticoider intramuskulært bruges frem for nasalsteroid og perorale antihistaminer til behandling af allergisk rhinoconjunctivitis udløst af pollen?
Væksthæmning (kritisk)
Knoglebrud (kritisk)
Diabetes (kritisk)
Livskvalitet (vigtig)
Fraværsdage fra skole/arbejde (vigtig)
Øjensymptomer (vigtig)
Tilstoppet næse (vigtig)
Næseflåd, klør og/eller nysen (vigtig)
Døsighed (vigtig)
Lokal atrofi (vigtig)
Observational study
Quality assessed with ACROBAT NRSi-tool: quality=moderat
Study design: Randomized controlled trial
Study grouping:
Open Label:
Cluster RCT:
Baseline Characteristics
Glucocorticoids intramuscular
Nasal steroids
Included criteria: Birch pollen allergy- > 15 years old- positive past anamnesis of allergic rhinoconjuctivitis during previous Birch pollen seasons.- positive skin prick test to Birch pollen
Excluded criteria: Continuous hyposensitisation, treatment with steroids 3 months prior to birch pollen season. Diabetes, arterial hypertension, liver diseases, thyroid gland, pregnancy.
Intervention Characteristics
Glucocorticoids intramuscular
Nasal steroids
Continuous:
Sponsorship source:
Country: Denmark
Setting:
Comments:
Authors name: L.C. Laursen, P Faurschou, EP Munch
Institution: Lung- and Allergy department, Frederiksberg County Hospital, Denmark.
Email:
Address:
Identification:
Participants:
Study design:
Baseline characteristics:
Intervention characteristics:
Pretreatment:
Continuous outcomes:
Dichotomous outcomes:
Adverse outcomes:
Study design: Randomized controlled trial
Study grouping:
Open Label:
Cluster RCT:
Baseline Characteristics
Glucocorticoids intramuscular
Nasal steroids
Included criteria: hay fever and typical nasal eye symtomsgrass and rye pollen allergy
Excluded criteria: <16 years old, pregnancy, ulcus ventriculi, diabetes, nasal polyps causing obstruction, chronic respiratory diseases, any systematic og infective disease at trial entry, hyposentisization during the previous 12 months and any medication taken before the study which could possible conceal symptoms of hay fever
Intervention Characteristics
Glucocorticoids intramuscular
Nasal steroids
Continuous:
Sponsorship source:
Country: Switzerland/Sweden
Setting:
Comments:
Authors name: WJ Pichler, T Klint, M. Blaser, W.Graf, K. Sauter, S.Weiss, K.Witschi
Institution: Institute for clinical Immunology, Bern Switzerland and AB Draco dept of clinical research, Lund Sweden
Email:
Address:
Identification:
Participants:
Study design:
Baseline characteristics:
Intervention characteristics:
Pretreatment:
Continuous outcomes:
Dichotomous outcomes:
Adverse outcomes:
Selection bias (biased allocation to interventions) due to inadequate generation of a randomised sequence
Comment: How the sequence for the allocation was made is unclear
Comment: The sequence generation was not described
Selection bias (biased allocation to interventions) due to inadequate concealment of allocations prior to assignment
Comment: concealment not described
Performance bias due to knowledge of the allocated interventions by participants and personnel during the study
Comment: They makes a double dummy treatment, even though patients propertly have tried steriod treatment before, and knows caracteterictics symptoms they get. It is a bit unclear described.relatively many persons in the Group with steroid injection didnt follow the prescribed treatment - they might have found our by feeling better that they get active treatment
Comment: Problem with colour of steroid injection and smell/taste nasal steroid
Detection bias due to knowledge of the allocated interventions by outcome assessors
Comment: It is unlickely that the blinding has been broken
Comment: Not described
Attrition bias due to amount, nature or handling of incomplete outcome data
Comment: It is unclear how they handlet missing data. Very little data is missing. One person left the study 9 patients didnt follow the treatment.
Comment: No patients dropped out and data is missing for one patient on one outcome.
Reporting bias due to selective outcome reporting
Comment: No protocol was located. They report reasonable outcomes; nothing obvius seems to be missing.
Comment: Protocol not located, they though report relevant outcomes.
Bias due to problems not covered elsewhere in the table
Comment: This study had all their medications provided from a famacutical compagny, it is unclear whether this could influence the results
Comment: The study was performed in 1988 where reporting standards were significantly different from what it is today. It is unclear whether funding sources or other bias should be taking into account.