Intranasal Versus Oral Treatments for Allergic Rhinitis: A Systematic Review With Meta-Analysis

• Type: Another Publication in an International Scientific Journal
• Date: 2024

Authors

Maria Inês Torres (Author) Other; Sara Gil-Mata (Author) Other; Antonio Bognanni (Author) Other; Renato Ferreira-da-Silva (Author) FMUP; Juan José Yepes-Nuñez (Author) Other; Nuno Lourenço-Silva (Author) Other; António Cardoso-Fernandes (Author) FMUP; André Ferreira (Author) Other; Henrique Ferreira-Cardoso (Author) Other; Diana Portela (Author) Other; João Teles (Author) Other; Violeta Kvedariene (Author) Other; María Jose Torres (Author) Other; Ludger Klimek (Author) Other; Oliver Pfaar (Author) Other; Luisa Brussino (Author) Other; Torsten Zuberbier (Author) Other; Fonseca, J (Author) FMUP; Holger Schünemann (Author) Other; Jean Bousquet (Author) Other; Bernardo Sousa-Pinto (Author) FMUP; Rafael José Vieira (Author) FMUP; Ana Luísa Neves (Author) Other; Ana Margarida Pereira (Author) Other; Anna Bedbrook (Author) Other; Arunas Valiulis (Author) Other; Cristina Jacomelli (Author) Other; Elena Azzolini (Author) Other; Elena Parmelli (Author) Other; Giorgio Walter Canonica (Author) Other; Jaron Zuberbier (Author) Other; Leticia de las Vecillas (Author) Other; Louis Gilles (Author) Other; Lucas Leemann (Author) Other; Ludger Klimek (Author) Other; Maria Teresa Ventura (Author) Other; Marine Savoure (Author) Other; Mark Dykewicz (Author) Other; Martin Hofmann-Apitius (Author) Other; Nikolaos Papadopoulos (Author) Other; Olga Lourenço (Author) Other; Sanna K. Salmi (Author) Other; Sian Williams (Author) Other; Yuliia Palamarchuk (Author) Other

Journal

Title: Journal of Allergy and Clinical Immunology: In Practice

Vol. 12

Pages: 3404-3418

ISSN: 2213-2198

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 4 Citations

Other information

Authenticus ID: P-016-X20

DOI: 10.1016/j.jaip.2024.09.001

Abstract (EN): BACKGROUND: Treatments for allergic rhinitis include intranasal or oral medications. OBJECTIVE: To perform a systematic review with meta-analysis comparing the effectiveness of intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists in improving allergic rhinitis symptoms and quality of life. METHODS: We searched four bibliographic databases and three clinical trial datasets for randomized controlled trials (1) assessing patients aged 12 years and older with seasonal or perennial allergic rhinitis, and (2) comparing intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists. We performed a meta-analysis of the Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score, Rhinoconjunctivitis Quality of Life Ques- tionnaire (RQLQ), development of adverse events, and withdrawals owing to adverse events. Certainty of evidence was assessed using Grading of Recommendations, Assess- ment, Development, and Evaluation. RESULTS: We included 35 studies, most of which assessed patients with seasonal allergic rhinitis and displayed an unclear risk of bias. Superiority of intranasal treatments was found for all assessed outcomes. Intranasal corticosteroids were more effective than oral antihistamines at improving the TNSS (mean difference [MD],- 0.86; 95% CI,- 1.21 to- 0.51; I 2 = 70%), Total Ocular Symptom Score (MD,- 0.36; 95% CI,- 0.56 to- 0.17; I 2 = 0%), and RQLQ (MD,- 0.88; 95% CI,- 1.15 to- 0.61; I 2 = 0%), which were mostly associated with clinically meaningful improvements. Superiority of intranasal corticosteroids at improving the TNSS was also found against oral leukotriene receptor antagonists (MD,- 1.05; 95% CI, - 1.33 to- 0.77). Intranasal antihistamines were more effective than oral antihistamines at improving the TNSS (MD,- 0.47; 95% CI,- 0.81 to- 0.14; I 2 = 0%) and RQLQ (MD,- 0.31; 95% CI,- 0.56 to- 0.06; I 2 = 0%). CONCLUSIONS: Randomized controlled trials suggest that intranasal treatments are more effective than oral treatments at improving symptoms and quality of life in seasonal allergic rhinitis. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY- NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/). (J Allergy Clin Immunol Pract 2024;12:3404-18)

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 15