Cochrane review: intranasal corticosteroids for non-allergic rhinitis


  • Mary Corcoran
  • Univadis Medical News
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A new Cochrane Review has concluded that it is “unclear” whether intranasal corticosteroids reduce patient‐reported disease severity in non‐allergic rhinitis patients compared with placebo when measured at up to three months.

The authors reviewed data from 34 randomised controlled trials including 4,452 participants, of which 13 studies (n=2,045) provided data for the main comparison between intranasal corticosteroids and placebo. 

The study found that when compared with placebo, intranasal corticosteroids may improve patient‐reported disease severity as measured by total nasal symptom score (TNSS) at up to four weeks; however, the authors said the evidence is very uncertain between four weeks and three months. The review also found treatment with intranasal corticosteroids “probably” increases the risk of epistaxis. 

The review also compared intranasal corticosteroids and other treatments such as saline irrigation and intranasal antihistamines. However, the authors noted there was not enough evidence to know whether intranasal corticosteroid treatment is superior.

“Overall, the certainty of the evidence for most outcomes in this review was low or very low. It is unclear whether intranasal corticosteroids reduce patient‐reported disease severity in non‐allergic rhinitis patients compared with placebo when measured at up to three months,” the authors concluded.