A systematic review and meta-analysis of efficacy and safety of compound glycyrrhizin combined with second-generation non-sedated antihistamine for the treatment of chronic urticaria

J Dermatolog Treat. 2024 Dec;35(1):2299597. doi: 10.1080/09546634.2023.2299597. Epub 2024 Jan 3.

Abstract

Background: Chronic urticaria (CU) is a prevalent dermatologic disease that negatively affects life, current therapies remain suboptimal. Hence, there is an urgent need to identify effective and safe treatment.

Objective: Assess the efficacy and safety of compound glycyrrhizin (CG) combined with second-generation nonsedated antihistamine for the treatment of CU.

Methods: Nine databases were queried to screen RCTs related. Two reviewers independently assessed the risk of bias using Cochrane Collaboration. Primary objective was the total efficiency rate, while secondary was rate of recurrence, adverse events, and cure. Statistical analyses using Review Manager 5.4 and Stata17.

Results: Twenty-four RCTs were identified. Significant differences were noted in rate of total efficiency (n = 2649, RR = 1.36, 95%CI:1.30-1.43, p < 0.00001), cure (n = 2649, RR = 1.54, 95%CI:1.42-1.66, p < 0.00001) and recurrence (n = 446, RR = 0.34, 95%CI:0.20-0.58, p < 0.00001) between the combination of CG with second-generation non-sedated antihistamine and antihistamine monotherapy. Contrastingly, adverse events rate (n = 2317, RR = 0.76, 95% CI:0.59-0.97, p = 0.03) was comparable between the two groups. Our results indicated that CG combined with second-generation non-sedated antihistamine could significantly mitigate the symptoms in CU compared with antihistamine monotherapy. No serious adverse events were reported.

Conclusions: CG combined with second-generation nonsedated antihistamine is effective for CU. Nevertheless, higher-quality studies are warranted to validate our results.

Keywords: Chronic urticaria; antihistamine. meta-analysis; compound glycyrrhizin capsule; compound glycyrrhizin injection; compound glycyrrhizin tablet.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Chronic Disease
  • Chronic Urticaria* / drug therapy
  • Glycyrrhizic Acid* / adverse effects
  • Glycyrrhizic Acid* / therapeutic use
  • Histamine Antagonists / adverse effects
  • Histamine Antagonists / therapeutic use
  • Histamine H1 Antagonists / adverse effects
  • Histamine H1 Antagonists / therapeutic use
  • Histamine H1 Antagonists, Non-Sedating* / adverse effects
  • Histamine H1 Antagonists, Non-Sedating* / therapeutic use
  • Humans

Substances

  • Glycyrrhizic Acid
  • Histamine Antagonists
  • Histamine H1 Antagonists
  • Histamine H1 Antagonists, Non-Sedating