As-needed versus regular intranasal corticosteroid for allergic rhinitis: A systematic review and meta-analysis.
Asian Pac J Allergy Immunol
; 40(3): 195-204, 2022 Sep.
Article
en En
| MEDLINE
| ID: mdl-35278059
ABSTRACT
BACKGROUND:
Daily intranasal corticosteroid (INCS) is recommended for treating allergic rhinitis (AR). Nevertheless, patients are generally not adherent and use it on-demand. The data on the efficacy of as-needed INCS was insufficient.OBJECTIVE:
We conducted a systematic review and meta-analysis to assess the efficacy of as-needed INCS compared with regular use for AR.METHODS:
We searched PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) until May 2021. A pairwise meta-analysis used a random-effects model to estimate the pooled standardized mean difference (SMD). The primary outcome was the total nasal symptom score (TNSS) changes from baseline at 4 and 6 weeks. Secondary outcomes were the changes of individual nasal symptom score and quality-of-life (QoL) score.RESULTS:
We identified five eligible RCTs with a total of 436 patients with AR. Only four studies had adequate data for quantitative synthesis. The TNSS changes of as-needed INCS were not significantly different from the regular use at both 4 (SMD 0.23 [95%CI -0.14 to 0.60], p = 0.230) and 6 weeks (SMD 0.21 [95%CI -0.02 to 0.44], p = 0.080). Most of the changes of individual nasal symptom scores and QoL scores were not significantly different between the two regimens. At 50% or more INCS dose of regular use, as-needed and regular INCS provided a similar efficacy. The treatment effect was, however, less sustained with as-needed INCS.CONCLUSIONS:
The efficacy of as-needed use of INCS at 50% of corticosteroid exposure was comparable to regular use in improving nasal symptoms and QoL.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Rinitis Alérgica
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Prognostic_studies
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Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Asian Pac J Allergy Immunol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Tailandia