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TOPLINE:

In patients with allergic rhinitis, fixed combinations of intranasal antihistamines and intranasal corticosteroids were associated with better quality-of-life outcomes than oral antihistamines or intranasal antihistamines alone.

METHODOLOGY:

• Researchers retrospectively evaluated patient-reported data to assess the effects of different drug classes for treating allergic rhinitis on health-related quality of life.
• Between 2015 and 2024 in a mobile app featuring a daily monitoring system, users recorded symptoms, medication use, and quality of life. Quality of life was assessed using health utility scores from the EuroQol Five-Dimension Five-Level questionnaire (EQ-5D-5L; range, 0.0-1.0) and the EQ-5D visual analog scale (EQ-5D VAS; range, 0-100); higher scores reflected better health status.
• The study evaluated 69,973 daily EQ-5D VAS responses from 4276 users (median age, 39 years; 56.2% women) and 842 EQ-5D-5L responses from 416 users (median age, 37 years; 60.8% women).
• The drug classes compared were oral antihistamines, intranasal corticosteroids, intranasal antihistamines, and fixed combinations of intranasal antihistamines and corticosteroids. Commonly used individual drugs within each class were also evaluated.

TAKEAWAY:

• Fixed combinations of intranasal antihistamines and corticosteroids were associated with more favorable outcomes, yielding higher EQ-5D VAS scores than those observed with oral antihistamines (mean difference [MD], 1.939; 95% CI, 1.355-2.523); the utility scores for fixed combinations tended to be higher than those for oral antihistamines and intranasal corticosteroids, but these differences were not statistically significant.
• Intranasal antihistamine monotherapy was linked to the least favorable outcomes, with lower EQ-5D VAS scores than those observed with all other drug classes.
• In patients using individual intranasal drugs, those who used mometasone reported lower EQ-5D VAS scores than those who used budesonide (MD, -5.288; 95% CI, -7.498 to -3.079).
• Among oral antihistamines, cetirizine was associated with higher EQ-5D VAS scores than fexofenadine and levocetirizine; levocetirizine was associated with higher scores than fexofenadine and loratadine.

IN PRACTICE:

“To the best of our knowledge, this is the first study to compare AR [allergic rhinitis] medications on EQ-5D VAS and utilities, allowing its results to be incorporated into cost-utility studies,” the authors of the study wrote.

SOURCE:

Jean Bousquet, MD, PhD, with Charité - Universitätsmedizin Berlin and corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, was the corresponding author of the study, which was published online on May 6, 2026, in Clinical & Experimental Allergy.

LIMITATIONS:

The study relied on self‑reported data, and measures of allergic rhinitis control immediately before medication use were unavailable. The utility score analysis included small sample sizes for several individual drug comparisons. Participating countries were unevenly represented.

DISCLOSURES:

No specific funding was received for this study. Several authors disclosed receiving personal fees, lecture honoraria, consulting fees, and/or grants from multiple pharmaceutical companies and organizations; some authors also reported having unpaid organizational affiliations or professional society memberships.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.