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The following is a summary of “Efficacy and safety of intranasal medications for allergic rhinitis: Network meta-analysis,” published in the November 2024 issue of Allergy and Immunology by Sousa-Pinto et al. 

Intranasal antihistamines (INAH), corticosteroids (INCS), and their combinations are key treatments for allergic rhinitis (AR). 

Researchers conducted a retrospective study comparing the efficacy and safety of INAH, INCS, and their combinations in patients with AR. 

They searched 4 bibliographic and 3 clinical trial databases for randomized controlled trials on INAH, INCS, and INAH+INCS in adults with AR. They performed a network meta-analysis on nasal and ocular symptom scores, quality of life (QoL), AEs, and withdrawals, assessing evidence certainty with GRADE-NMA. 

The results showed that azelastine-fluticasone and fluticasone furoate were the highest-ranked for efficacy in seasonal AR. INAH+INCS ranked highest for all outcomes, followed by INCS. Evidence certainly was high or moderate in 105 of 184 seasonal AR comparisons and 28 of 97 perennial AR comparisons. 

Investigators found clinically significant efficacy differences among intranasal medications for AR, with all showing a good safety profile. This network meta-analysis provided valuable evidence for clinicians and guideline developers on the most effective treatments. 

Source: onlinelibrary.wiley.com/doi/full/10.1111/all.16384