Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis

Li, Chia‐Ling; Lin, Hsiao-Chuan; Lin, Chien‐Yu; Hsu, Teh‐Fu

doi:10.3390/jcm8010064

Cited by 25 publications

(25 citation statements)

References 38 publications

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“…However, all studies investigating this intervention were rated as high overall RoB. Li et al 50 conducted a review and meta‐analysis of the efficacy of nasal irrigation in AR. Based on the results, Li et al 50 concluded that HSNI is an effective therapy for children with AR, as HSNI lead to a significantly higher improvement of nasal symptoms and reduction in drug intake in comparison with ISNI.…”

Section: Discussionmentioning

confidence: 99%

Non‐pharmacological interventions for pollen‐induced allergic symptoms: Systematic literature review

Schutzmeier

Kutzora²,

Mittermeier³

et al. 2021

Pediatric Allergy Immunology

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Background: Allergic diseases pose a health problem worldwide. Pollen are widespread aeroallergens which can cause symptoms like shortness of breath, cough, itchy eyes, or rhinitis. Apart from preventive measures and pharmacological treatment, also non-pharmacological interventions have been suggested to reduce symptoms. The objective of this work was to review studies investigating the effectiveness of nonpharmacologic interventions to reduce allergic symptoms. Methods: PubMed, EMBASE, and CENTRAL were systematically reviewed in July 2018 and April 2020. Several authors worked on the screening of titles, abstracts, 2 of 13 | SCHUTZMEIER ET al. | INTRODUC TI ONAllergic rhinitis (AR) and asthma pose a worldwide health issue. 1 International studies like the European Community RespiratoryHealth Survey and the International Study of Asthma and Allergies in Childhood showed that AR and asthma are prevalent in most countries. 2,3 The global prevalence of AR is between 10% and 30% in adults and at least 40% in children. 4 AR is associated with immunoglobulin-E type antibody (IgE)mediated immune response to allergens causing inflammations. The most common symptoms are rhinorrhea, blocked nose, nasal itching, sneezing, and ocular symptoms. 5 AR is associated with the development of asthma. 6,7 Both AR and asthma can be triggered by airborne pollen. 8 Apart from allergenspecific immunotherapy as the only causal treatment, 9,10 there is a variety of effective medication and guidelines to control symptoms, for example, second-generation antihistamine or intranasal glucocorticoids. Bousquet et al. 11 showed that symptoms of AR are under control in only about one third of the patients who received optimal pharmacological treatment. The objective of this paper is to review studies on the effectiveness of non-pharmacologic interventions (NPI) to reduce allergic symptoms due to pollen. | ME THODSThe "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) checklist has been used to carry out this systematic review (Appendix S1: ESM 1). [12][13][14] The review was prepared in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. 15 The review is registered in the "International Prospective Register of Systematic Reviews" (PROSPERO: CRD42019106131). | Search strategyThe search strategy was conducted by using PECOs (Tables 1 and 2):Studies that investigated the efficacy of NPI in people with allergic and full texts. One author for each literature search performed the data extraction and the risk of bias assessment. Studies were included if they met the inclusion criteria defined by the PECOs. Studies which investigating the effect of non-pharmacologic interventions on patients with allergic rhinitis were included.Results: Twenty-nine studies investigating eleven types of non-pharmacologic interventions to avoid and reduce allergic symptoms due to pollen exposure were included in this review. Out of all studies, seven studies addressed nasal rinsing and 22 included acupuncture, air filt...

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Section: Discussionmentioning

confidence: 99%

Non‐pharmacological interventions for pollen‐induced allergic symptoms: Systematic literature review

Schutzmeier

Kutzora²,

Mittermeier³

et al. 2021

Pediatric Allergy Immunology

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“…Garavello et al 28 found a significant reduction in the mean consumption of antihistamines in children with allergic rhinitis treated with hypertonic saline irrigation during the third, fourth, and sixth weeks of the study. Li et al 29 demonstrated a reduction in rescue antihistamine usage in pediatric allergic rhinitis when treated with hypertonic or isotonic saline nasal irrigation. The current study results may have additional significance in patients who have difficulty tolerating nasal steroid sprays either due to side effects or intolerance to any of the components.…”

Section: Discussionmentioning

confidence: 99%

Budesonide vs Saline Nasal Irrigation in Allergic Rhinitis: A Randomized Placebo‐Controlled Trial

Periasamy

Pujary

Bhandarkar

et al. 2020

Otolaryngol.--head neck surg.

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Objectives Budesonide nasal irrigation is currently widely used in the treatment of chronic sinusitis typically following endoscopic sinus surgery to improve inflammatory control. Its application in treatment of allergic rhinitis has not been previously studied. This study assesses the subjective and clinical response to budesonide buffered hypertonic saline nasal irrigation and hypertonic saline nasal irrigation in patients with allergic rhinitis. Study Design This is a prospective, single-center, double-blind, randomized placebo-controlled trial. Setting Tertiary care hospital. Subjects and Methods Fifty-two patients diagnosed with allergic rhinitis were randomized into 2 groups to receive either buffered hypertonic saline nasal irrigation with a placebo respule or buffered hypertonic saline nasal irrigation with a budesonide respule. Patients were assessed at baseline and 4 weeks subjectively using the Sino-Nasal Outcome Test–22 (SNOT-22) questionnaire and visual analog scale (VAS). Clinical assessment was done using the modified Lund-Kennedy score. Results The average SNOT-22, VAS, and modified Lund-Kennedy scores improved in both groups ( P < .001). The budesonide irrigation group was found to have significantly better improvement than the saline nasal irrigation group with the SNOT-22 scores ( P = .012) and VAS scores ( P = .007). However, the difference in the clinical response between the 2 groups was not significant ( P = .268). Conclusion This study adds evidence to the use of saline nasal irrigation in allergic rhinitis but also demonstrates efficacy of the addition of budesonide to irrigations. Budesonide nasal irrigation thus appears to be a viable treatment option for allergic rhinitis.

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“…Li, 2019 [110] Systematic review and meta-analysis literature following the PRISMA guidelines Allergic rhinitis in children Hypertonic saline nasal irrigation Hypertonic saline treatment improved patients' nasal symptom scores and significantly lower rescue antihistamine use rate. Analyses comparing hypertonic with isotonic saline nasal irrigation better nasal symptom scores in hypertonic group, although the antihistamine use and adverse effect rates were similar between groups.…”

Section: Bronchiolitis In Infantsmentioning

confidence: 99%

The Role of Seawater and Saline Solutions in Treatment of Respiratory Conditions

Štanfel¹,

Kalogjera²,

Ryazantsev³

et al. 2022

Preprint

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The history of saline nasal irrigation (SNI) is indeed a long one, beginning from the ancient Ayurvedic practices and starting to gain a foothold in the west at the beginning of 20th century. Today, there is a growing number of papers covering effects of SNI from in vitro studies to randomized clinical trials and literature overviews. Based on the recommendations of most of the European and American professional associations, seawater, alone or in combination with other preparations, has its place in treatment of numerous conditions of the upper respiratory tract (URT), primarily in chronic (rhino)sinusitis, allergic rhinitis, acute URT infections and postoperative recovery. Additionally, taking into account its multiple mechanisms of action and mounting evidence from recent studies, locally applied seawater preparations may have an important role in prevention of viral and bacterial infections of the URT. Therefore, in this review we discuss results published in the past years focused on the seawater preparations and their use in clinical and everyday conditions, since such products are superior to saline, have an excellent safety profile and are recommended by most professional associations in the field of otorhinolaryngology.

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Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 38 publications

Non‐pharmacological interventions for pollen‐induced allergic symptoms: Systematic literature review

Non‐pharmacological interventions for pollen‐induced allergic symptoms: Systematic literature review

Budesonide vs Saline Nasal Irrigation in Allergic Rhinitis: A Randomized Placebo‐Controlled Trial

The Role of Seawater and Saline Solutions in Treatment of Respiratory Conditions

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