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TOPLINE:

The administration of intranasal medications alleviated nasal symptoms and was safe for treating seasonal and perennial allergic rhinitis (AR) in children, although they appeared less effective than in adults.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis of 31 studies to compare the efficacy and safety of intranasal corticosteroids, intranasal antihistamines, and fixed combinations of both for treating seasonal and perennial AR in children younger than 18 years.
• The minimum follow-up duration was 2 and 4 weeks for patients with seasonal and perennial AR, respectively.
• The treatment efficacy was assessed on the basis of improvements in nasal symptoms, ocular symptoms, overall symptom severity, and quality of life measured as the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS), the Total Symptom Score (TSS), and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), respectively.

TAKEAWAY:

• In patients with seasonal AR, treatment with a combination of both corticosteroid and antihistamine was associated with a higher probability of clinically meaningful improvements in the TNSS (25.9%), TOSS (56.3%), and RQLQ (47.0%) than treatment with intranasal corticosteroids alone.
• Compared with treatment with placebo, treatment with a combination of both was associated with significant improvements in the TNSS, TSS, and RQLQ in patients with seasonal AR.
• In patients with perennial AR, treatment with intranasal corticosteroids was associated with a 42.3% probability of a clinically meaningful improvement in the RQLQ compared with treatment with intranasal antihistamines.
• No significant differences in the risk for adverse events were observed among the various medication classes.

IN PRACTICE:

“This systematic review and NMA [network meta-analysis] will provide evidence for guideline developers and clinicians on the comparison between different intranasal medication classes for children with either SAR [seasonal allergic rhinitis] or PAR [perennial allergic rhinitis],” the authors of the study wrote.

SOURCE:

Jean Bousquet, PhD, with the Institute of Allergology, Charité — Universitätsmedizin Berlin, Berlin, Germany, was the corresponding author of the study, which was published online on July 14 in TheJournal of Allergy and Clinical Immunology: In Practice.

LIMITATIONS:

This study was limited by missing data on the TOSS for patients with perennial AR, the exclusion of some randomized controlled trials from the network meta‐analysis due to inconsistent scoring methods, and low-to-very low certainty of evidence for most comparisons between active treatments.

DISCLOSURES:

Some authors reported serving as board members and chairpersons and receiving contracts, grants, and consulting/personal fees from multiple organizations and pharmaceutical companies.

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