Efficacy and safety of intranasal medications for allergic rhinitis: Network meta-analysis

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

Authors

Sousa-Pinto, B (Author) FMUP; Vieira, RJ (Author) FMUP; Bognanni, A (Author) Other; Gil-Mata, S (Author) Other; Ferreira-da-Silva, R (Author) FMUP; Ferreira, A (Author) Other; Cardoso-Fernandes, A (Author) FMUP; Ferreira-Cardoso, H (Author) Other; Marques-Cruz, M (Author) Other; Duarte, VH (Author) Other; Castro-Teles, J (Author) Other; Campos-Lopes, M (Author) Other; Teixeira-Ferreira, A (Author) Other; Lourenco-Silva, N (Author) Other; Chérrez-Ojeda, I (Author) Other; Bedbrook, A (Author) Other; Klimek, L (Author) Other; Nuñez, JJY (Author) Other; Zuberbier, T (Author) Other; Fonseca, JA (Author) Other; Schünemann, HJ (Author) Other; Bousquet, J (Author) Other

Journal

Title: Allergy: European Journal of Allergy and Clinical Immunology

ISSN: 0105-4538

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 3 Citations

Scopus - 3 Citations

Other information

Authenticus ID: P-017-JJT

DOI: 10.1111/all.16384

Abstract (EN): BackgroundIntranasal antihistamines (INAH), corticosteroids (INCS), and their fixed combinations (INAH+INCS) are one of the cornerstones of the treatment of allergic rhinitis (AR). We performed a systematic review and network-meta-analysis comparing the efficacy and safety of INAH, INCS, and INAH+INCS in patients with AR.MethodsWe searched four electronic bibliographic databases and three clinical trial databases for randomised controlled trials assessing the use of INAH, INCS, and INAH+INCS in adults with seasonal or perennial AR. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence was assessed using GRADE-NMA.ResultsWe included 167 primary studies, most of which assessed patients with seasonal AR. Among individual medications, azelastine-fluticasone, and fluticasone furoate were the most frequently highest-ranked interventions for efficacy outcomes, being regularly associated with clinically meaningful larger improvements when compared to other active treatments. Considering drug classes, INAH+INCS were the highest-ranked interventions for all outcomes in which they were assessed, followed in most cases by INCS. In 105 out of 184 comparisons in seasonal AR, and 28 out of 97 comparisons in perennial AR, certainty of evidence was considered high or moderate.ConclusionIntranasal medications for AR display clinically relevant differences in their efficacy, but all show a good safety profile. To our knowledge, this is the first network meta-analysis comparing INAH, INCS, and INAH+INCS in AR, providing relevant evidence for guideline developers and practising physicians on the most efficacious treatments.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 12