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

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

Authors

Torres, MI (Author) Other; Gil Mata, S (Author) Other; Bognanni, A (Author) Other; Ferreira da Silva, R (Author) FMUP; Yepes Nuñez, JJ (Author) Other; Lourenço Silva, N (Author) Other; Cardoso Fernandes, A (Author) FMUP; Ferreira, A (Author) Other; Ferreira Cardoso, H (Author) Other; Portela, D (Author) Other; Teles, J (Author) Other; Kvedariene, V (Author) Other; Torres, MJ (Author) Other; Klimek, L (Author) Other; Pfaar, O (Author) Other; Brussino, L (Author) Other; Zuberbier, T (Author) Other; Fonseca, J (Author) FMUP; Schünemann, H (Author) Other; Bousquet, J (Author) Other; Sousa Pinto, B (Author) FMUP; Vieira, RJ (Author) FMUP; Neves, AL (Author) Other; Pereira, AM (Author) Other; Bedbrook, A (Author) Other; Valiulis, A (Author) Other; Jacomelli, C (Author) Other; Azzolini, E (Author) Other; Parmelli, E (Author) Other; Canonica, GW (Author) Other; Zuberbier, J (Author) Other; Vecillas, Ldl (Author) Other; Gilles, L (Author) Other; Leemann, L (Author) Other; Klimek, L (Author) Other; Ventura, MT (Author) Other; Savoure, M (Author) Other; Dykewicz, M (Author) Other; Hofmann Apitius, M (Author) Other; Papadopoulos, N (Author) Other; Lourenço, O (Author) Other; Salmi, SK (Author) Other; Williams, S (Author) Other; Palamarchuk, Y (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 - 1 Citation

Scopus - 1 Citation

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