(A1104) Aqueous versus Aerosol Intranasal Corticosteroid Spray for Allergic Rhinitis: Systematic Review and Meta-Analysis

Introduction: Allergic rhinitis (AR) affects millions of people worldwide, impacting the quality of life and causing economic burden. INCS is the mainstay treatment for AR, delivered via aerosol or aqueous sprays. This systematic review and meta-analysis investigate the comparative efficacy and safety of these delivery methods.

Methods: In this systematic review and meta-analysis, two independent reviewers searched four databases (Embase via Elsevier, Cochrane Central Register of Controlled Trials via Wiley, PubMed via NLM NIH, and Web of Science via Clarivate) for English-language, prospective randomized controlled trials (RCTs) from inception through February 14, 2024. The studies compared aqueous and aerosol intranasal corticosteroids (INCs) for the treatment of allergic rhinitis (AR). Studies were excluded if they involved incorrect comparisons, lacked full text, provided insufficient data for extraction, included the wrong patient population, used a non-intranasal route of administration, or had unverifiable inclusion criteria. The primary outcomes were the Total Nasal Symptom Score (TNSS) and its subset scores. Secondary outcomes included physician and patient assessments as well as adverse events (AEs).

Results: No significant difference in overall TNSS was found between the delivery methods. However, aqueous sprays showed a slight edge in reducing specific symptoms like congestion, itching, sneezing, and rhinorrhea. Physician/patient assessments and AEs did not differ significantly.

Conclusions: Our findings suggest no significant difference in efficacy or safety between aerosol and aqueous INCs for AR treatment. Patient preference should be a primary consideration when choosing a delivery method to optimize adherence and symptom control.