TY - JOUR
T1 - Intranasal corticosteroids compared with oral antihistamines in allergic rhinitis
T2 - A systematic review and meta-analysis
AU - Juel-Berg, Nanna
AU - Darling, Peter
AU - Bolvig, Julie
AU - Foss-Skiftesvik, Majken H
AU - Halken, Susanne
AU - Winther, Lone
AU - Hansen, Kirsten Skamstrup
AU - Askjaer, Nikolaj
AU - Heegaard, Steffen
AU - Madsen, Anders R
AU - Opstrup, Morten S
PY - 2017/1/1
Y1 - 2017/1/1
N2 - BACKGROUND: Intranasal corticosteroids (INS) (corticosteroid nasal sprays) and oral antihistamines (OA) are two of the most common treatments for patients with allergic rhinitis (AR). To our knowledge, there are no systematic reviews on this topic including trials published after 2007.OBJECTIVE: To compare INS with nonsedating OAs as treatments for AR.METHODS: The systematic review and meta-analysis were based on the Grades of Recommendation, Assessment, Development, and Evaluation principles and the Patient, Intervention, Comparison, and Outcome approach. Primary literature was searched up to January 22, 2015. Criteria for eligibility were randomized controlled trials that compared the efficacy and/or adverse effects of INS and OA in patients with AR. Continuous outcome data were analyzed by using standardized mean differences (SMD) for multiple outcome measures, and mean differences in the case of a single study or outcome. Pooled estimates of effects, 95% confidence interval (CI), were calculated by using random-effects models.RESULTS: The meta-analysis included five randomized controlled trials with a total of 990 patients. INS were superior to OAs in improving total nasal symptoms score (SMD -0.70 [95% CI, -0.93 to -0.47]) and in relieving the following: nasal obstruction (SMD -0.56 [95% CI, -0.82 to -0.29]), rhinorrhea (SMD -0.47 [95% CI, -1.00 to 0.05]), nasal itching (SMD -0.42 [95% CI, -0.65 to -0.18]), sneezing (SMD -0.52 [95% CI, -0.73 to -0.32]), and quality of life mean difference -0.90 [95% CI, -1.18 to -0.62]). There was no difference in relief of ocular symptoms (SMD -0.08 [95% CI, -0.23 to 0.08]). In addition, four randomized controlled trials were included in a narrative analysis. The results in the narrative analysis were comparable with those found in the meta-analysis.CONCLUSION: INS were superior to OAs in improving nasal symptoms and quality of life in patients with AR.
AB - BACKGROUND: Intranasal corticosteroids (INS) (corticosteroid nasal sprays) and oral antihistamines (OA) are two of the most common treatments for patients with allergic rhinitis (AR). To our knowledge, there are no systematic reviews on this topic including trials published after 2007.OBJECTIVE: To compare INS with nonsedating OAs as treatments for AR.METHODS: The systematic review and meta-analysis were based on the Grades of Recommendation, Assessment, Development, and Evaluation principles and the Patient, Intervention, Comparison, and Outcome approach. Primary literature was searched up to January 22, 2015. Criteria for eligibility were randomized controlled trials that compared the efficacy and/or adverse effects of INS and OA in patients with AR. Continuous outcome data were analyzed by using standardized mean differences (SMD) for multiple outcome measures, and mean differences in the case of a single study or outcome. Pooled estimates of effects, 95% confidence interval (CI), were calculated by using random-effects models.RESULTS: The meta-analysis included five randomized controlled trials with a total of 990 patients. INS were superior to OAs in improving total nasal symptoms score (SMD -0.70 [95% CI, -0.93 to -0.47]) and in relieving the following: nasal obstruction (SMD -0.56 [95% CI, -0.82 to -0.29]), rhinorrhea (SMD -0.47 [95% CI, -1.00 to 0.05]), nasal itching (SMD -0.42 [95% CI, -0.65 to -0.18]), sneezing (SMD -0.52 [95% CI, -0.73 to -0.32]), and quality of life mean difference -0.90 [95% CI, -1.18 to -0.62]). There was no difference in relief of ocular symptoms (SMD -0.08 [95% CI, -0.23 to 0.08]). In addition, four randomized controlled trials were included in a narrative analysis. The results in the narrative analysis were comparable with those found in the meta-analysis.CONCLUSION: INS were superior to OAs in improving nasal symptoms and quality of life in patients with AR.
KW - Administration, Intranasal
KW - Administration, Oral
KW - Adrenal Cortex Hormones
KW - Humans
KW - Quality of Life
KW - Rhinitis, Allergic
KW - Treatment Outcome
KW - Comparative Study
KW - Journal Article
KW - Meta-Analysis
KW - Review
U2 - 10.2500/ajra.2016.30.4397
DO - 10.2500/ajra.2016.30.4397
M3 - Review
C2 - 28234147
SN - 1945-8924
VL - 31
SP - e19-e28
JO - American Journal of Rhinology & Allergy
JF - American Journal of Rhinology & Allergy
IS - 1
ER -