Efficacy of different oral H1 antihistamine treatments on allergic rhinitis: a systematic review and network meta-analysis of randomized controlled trials

Hong, Dongdong; Weng, Juanling; Ye, Meiting; Liu, Yuanxian

doi:10.1016/j.bjorl.2023.03.009

Brazilian Journal of Otorhinolaryngology

2023

DOI: 10.1016/j.bjorl.2023.03.009

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Efficacy of different oral H1 antihistamine treatments on allergic rhinitis: a systematic review and network meta-analysis of randomized controlled trials

Dongdong Hong¹,

Juanling Weng²,

Meiting Ye³

et al.

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2024

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

Sousa‐Pinto,

Vieira,

Bognanni

et al. 2024

Allergy

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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.

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

Sousa‐Pinto,

Vieira,

Bognanni

et al. 2024

Allergy

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show abstract

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Efficacy of different oral H1 antihistamine treatments on allergic rhinitis: a systematic review and network meta-analysis of randomized controlled trials

Cited by 1 publication

References 23 publications

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

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

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