Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis
No evidence shows that one intranasal corticosteroid (INCS) is better than another for treating moderate-to-severe allergic rhinitis (AR). This network meta-analysis assessed the comparative efficacy and acceptability of licensed dose aqueous INCSs. PubMed/MEDLINE, Scopus, EMBASE, and the Cochrane C...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full |
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| author | Kay Khine Soe Thanachit Krikeerati Chatkamol Pheerapanyawaranun Suvimol Niyomnaitham Phichayut Phinyo Phichayut Phinyo Phichayut Phinyo Torpong Thongngarm |
| author_facet | Kay Khine Soe Thanachit Krikeerati Chatkamol Pheerapanyawaranun Suvimol Niyomnaitham Phichayut Phinyo Phichayut Phinyo Phichayut Phinyo Torpong Thongngarm |
| author_sort | Kay Khine Soe |
| collection | DOAJ |
| description | No evidence shows that one intranasal corticosteroid (INCS) is better than another for treating moderate-to-severe allergic rhinitis (AR). This network meta-analysis assessed the comparative efficacy and acceptability of licensed dose aqueous INCSs. PubMed/MEDLINE, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 31 March 2022. Eligible studies included randomized controlled trials comparing INCSs with placebo or other types of INCSs in patients with moderate-to-severe allergic rhinitis. Two reviewers independently screened and extracted data following the Preferred Reporting Items in Systematic Reviews and Meta-analysis guideline. A random-effects model was used for data pooling. Continuous outcomes were expressed as standardized mean difference (SMD). The primary outcomes were the efficacy in improving total nasal symptom score (TNSS) and treatment acceptability (the study dropout). We included 26 studies, 13 with 5,134 seasonal AR patients and 13 with 4,393 perennial AR patients. Most placebo-controlled studies had a moderate quality of evidence. In seasonal AR, mometasone furoate (MF) was ranked the highest efficacy, followed by fluticasone furoate (FF), ciclesonide (CIC), fluticasone propionate and triamcinolone acetonide (TAA) (SMD −0.47, 95% CI: −0.63 to −0.31; −0.46, 95% CI: −0.59 to −0.33; −0.44, 95% CI: −0.75 to −0.13; −0.42, 95% CI: −0.67 to −0.17 and −0.41, 95% CI: −0.81 to −0.00), In perennial AR, budesonide was ranked the highest efficacy, followed by FF, TAA, CIC, and MF (SMD −0.43, 95% CI: −0.75 to −0.11; −0.36, 95% CI: −0.53 to −0.19; −0.32, 95% CI: −0.54 to −0.10; −0.29, 95% CI: −0.48 to −0.11; and −0.28, 95% CI: −0.55 to −0.01). The acceptability of all included INCSs was not inferior to the placebo. According to our indirect comparison, some INCSs have superior efficacy to others with moderate quality of evidence in most placebo-controlled studies for treating moderate-to-severe AR. |
| first_indexed | 2024-03-13T10:02:24Z |
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| last_indexed | 2024-03-13T10:02:24Z |
| publishDate | 2023-05-01 |
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| spelling | doaj.art-a8101075ee2247598d15a3cc551e6da82023-05-23T04:54:18ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-05-011410.3389/fphar.2023.11845521184552Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysisKay Khine Soe0Thanachit Krikeerati1Chatkamol Pheerapanyawaranun2Suvimol Niyomnaitham3Phichayut Phinyo4Phichayut Phinyo5Phichayut Phinyo6Torpong Thongngarm7Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandMusculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, ThailandDivision of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandNo evidence shows that one intranasal corticosteroid (INCS) is better than another for treating moderate-to-severe allergic rhinitis (AR). This network meta-analysis assessed the comparative efficacy and acceptability of licensed dose aqueous INCSs. PubMed/MEDLINE, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 31 March 2022. Eligible studies included randomized controlled trials comparing INCSs with placebo or other types of INCSs in patients with moderate-to-severe allergic rhinitis. Two reviewers independently screened and extracted data following the Preferred Reporting Items in Systematic Reviews and Meta-analysis guideline. A random-effects model was used for data pooling. Continuous outcomes were expressed as standardized mean difference (SMD). The primary outcomes were the efficacy in improving total nasal symptom score (TNSS) and treatment acceptability (the study dropout). We included 26 studies, 13 with 5,134 seasonal AR patients and 13 with 4,393 perennial AR patients. Most placebo-controlled studies had a moderate quality of evidence. In seasonal AR, mometasone furoate (MF) was ranked the highest efficacy, followed by fluticasone furoate (FF), ciclesonide (CIC), fluticasone propionate and triamcinolone acetonide (TAA) (SMD −0.47, 95% CI: −0.63 to −0.31; −0.46, 95% CI: −0.59 to −0.33; −0.44, 95% CI: −0.75 to −0.13; −0.42, 95% CI: −0.67 to −0.17 and −0.41, 95% CI: −0.81 to −0.00), In perennial AR, budesonide was ranked the highest efficacy, followed by FF, TAA, CIC, and MF (SMD −0.43, 95% CI: −0.75 to −0.11; −0.36, 95% CI: −0.53 to −0.19; −0.32, 95% CI: −0.54 to −0.10; −0.29, 95% CI: −0.48 to −0.11; and −0.28, 95% CI: −0.55 to −0.01). The acceptability of all included INCSs was not inferior to the placebo. According to our indirect comparison, some INCSs have superior efficacy to others with moderate quality of evidence in most placebo-controlled studies for treating moderate-to-severe AR.https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/fullacceptabilityallergic rhinitisefficacyintranasal corticosteroidmeta-analysissystematic review |
| spellingShingle | Kay Khine Soe Thanachit Krikeerati Chatkamol Pheerapanyawaranun Suvimol Niyomnaitham Phichayut Phinyo Phichayut Phinyo Phichayut Phinyo Torpong Thongngarm Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis Frontiers in Pharmacology acceptability allergic rhinitis efficacy intranasal corticosteroid meta-analysis systematic review |
| title | Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis |
| title_full | Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis |
| title_fullStr | Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis |
| title_full_unstemmed | Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis |
| title_short | Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis |
| title_sort | comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate to severe allergic rhinitis a systematic review and network meta analysis |
| topic | acceptability allergic rhinitis efficacy intranasal corticosteroid meta-analysis systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full |
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