Topical treatments for seasonal allergic conjunctivitis
Clinical bottom line
There is insufficient evidence to be sure which is the best treatment. The best evidence is a large effect for sodium cromogylcate.
Reference
CG Owen et al. Topical treatments for seasonal allergic conjunctivitis: systematic review and meta-analysis of efficacy and effectiveness. British Journal of General Practice 2004 54: 451-456.
Searching
Studies were identified from a Cochrane specialist register, and wider searching, up to 2001, together with several electronic searches. Trials selected had to randomised and double blind with subjective assessment of treatment efficacy.
Results
Because results are given only as odds ratios, with are uninterpretable, and with no indication of percentages of patients were benefiting, only a bare outline or results can be given. In general, only small numbers of small trials were available.
A summary was:
- Sodium cromoglyacte had a high odds ratio (17) for perceived benefit compared with placebo in six trials with about 300 patients.
- Nedocromil glycate had a significant increase in perceived benefit over placebo (odds ratio 1.8) in five trials with about 500 patients.
- Lodoxamide tromethamine had only one very small randomised trial.
- Topical antihistamines in nine trials, usually in provocation trials that are not wholly relevant.
- Comparing mast cell stabilisers against antihistamines in four small trials showed no difference.
Comment
There is insufficient evidence to be sure which is the best treatment. The best evidence is a large effect for sodium cromogylcate.