. Author manuscript; available in PMC: 2020 Jun 10.

Published in final edited form as: Int Forum Allergy Rhinol. 2018 Feb;8(2):108–352. doi: 10.1002/alr.22073

TABLE IX.B.2.c-3.

Comparison of intranasal corticosteroids to other agents for the treatment of allergic rhinitis

Study	Year	LOE	Study design	Study groups	Clinical endpoint	Conclusion
Benninger et al.¹²⁹⁹	2010	1a	SR of RCTs of at least 2-week duration, and studying U.S.-approved INCS indication/dose	SAR: 38 studies (n = 11,980 adults, 946 children); PAR: 12 studies (n = 3800 adults, 366 children).	Median percentage changes from baseline for TNSS.	INCS produce the greatest improvements in nasal symptoms in SAR. INCS effective for PAR, but data quality variable; oral antihistamines may be equally effective for some patients.
Wilson et al.¹³⁰⁰	2004	1a	SR and meta-analysis of RCTs of the effectiveness of LTRAs	SAR: 11 studies. 8 evaluating LTRAs (alone or plus other treatments) vs placebo or other treatments (n = 3924); 3 evaluating LTRAs plus antihistamine (n = 80).	Composite daily rhinitis symptom scores and rhinitis-specific quality of life.	LTRAs are modestly better than placebo, as effective as antihistamines, but less effective than INCS in improving symptoms and QOL in patients with SAR.
Yanez & Rodrigo¹²⁹⁸	2002	1a	SR of RCTs	AR: 9 studies (n = 648). INCS vs topical antihistamines.	Total nasal symptoms, sneezing, rhinorrhea, itching, and nasal blockage.	INCS produced greater relief of nasal symptoms vs topical antihistamines. No difference between the 2 treatments for ocular symptoms.
Weiner et al.¹²⁹⁷	1998	1a	Meta-analysis of RCTs	AR: 16 studies (n = 2267). INCS vs oral antihistamines.	Nasal blockage, nasal discharge, sneezing, nasal itch, postnasal drip, nasal discomfort, total nasal symptoms, nasal resistance, and eye symptoms and global ratings.	INCS produced greater relief of nasal blockage, nasal discharge, sneezing, nasal itch, postnasal drip, and total nasal symptoms vs oral antihistamines. No difference between the 2 treatments for nasal discomfort, nasal resistance, or eye symptoms.

AR = allergic rhinitis; INCS = intranasal corticosteroid; LOE = level of evidence; LTRA = leukotriene receptor antagonist; PAR = perennial allergic rhinitis; QOL = quality of life; RCT = randomized controlled trial; SAR = seasonal allergic rhinitis; SR = systematic review; TNSS = Total Nasal Symptom Score.