Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials.

Abstract

RATIONALE:

Several randomized, double-blind, placebo-controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta-analysis to determine the overall treatment effect.

METHODS:

A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double-blind, placebo-controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non-nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta-analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software.

DATA SYNTHESIS:

Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD -0.49, 95% CI: -0.60 to -0.38; P < 0.00001; I(2) = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (-0.41; 95% CI: -0.56 to -0.27), rhinorrhoea (-0.44; 95% CI: -0.66 to -0.21), sneezing (-0.40; 95% CI: -0.57 to -0.23) and nasal itching (-0.39; 95% CI: -0.53 to -0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (-0.30; 95% CI: -0.43 to -0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81-1.20; P = 0.91).

CONCLUSIONS:

This meta-analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.

• Authors: M Penagos, E Compalati, F Tarantini, C E Baena-Cagnani, G Passalacqua, G W Canonica
• Journal: Allergy (Allergy) Vol. 63 Issue 10 Pg. 1280-91 (Oct 2008) ISSN: 1398-9995 [Electronic] Denmark
• PMID: 18721246 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anti-Allergic Agents
• Placebos
• Pregnadienediols
• Mometasone Furoate

Topics

• Administration, Intranasal
• Anti-Allergic Agents (administration & dosage, adverse effects, therapeutic use)
• Double-Blind Method
• Humans
• Mometasone Furoate
• Placebos
• Pregnadienediols (administration & dosage, adverse effects, therapeutic use)
• Randomized Controlled Trials as Topic (methods)
• Rhinitis, Allergic, Perennial (drug therapy)
• Rhinitis, Allergic, Seasonal (drug therapy)