BACKGROUND While the efficacy of medications such as fluticasone furoate(FF),fluticasone propionate(FP),and azelastine-fluticasone(AF)has been substantiated in comparison to their respective placebo controls,uncertain...BACKGROUND While the efficacy of medications such as fluticasone furoate(FF),fluticasone propionate(FP),and azelastine-fluticasone(AF)has been substantiated in comparison to their respective placebo controls,uncertainties persist regarding the comparative effectiveness of different intranasal agents.AIM To evaluate the efficacy of FP,FF,and AF in the treatment of adult patients with seasonal allergic rhinitis(SAR)using a meta-analytic approach.METHODS A computer search was conducted in Cochrane Library,PubMed,and EMBASE databases to identify randomized controlled trials assessing the effectiveness and safety of FF,FP,and AF in treating SAR.Data on treatment safety and efficacy were extracted and analyzed through meta-analysis.RESULTS A total of 20 studies were included,comprising 10590 participants.The results of the direct meta-analysis indicated that,compared to placebo,both relative Total Nasal Symptom Score(rTNSS)and relative Total Ocular Symptom Score(rTOSS)significantly decreased post-intervention[mean difference(MD)=-1.48,95%confidence interval(CI):-1.73 to-1.22;MD=-0.66,95%CI:-0.82 to-0.49],with similar findings observed across the FF,FP,and AF subgroups.The network meta-analysis results showed that for improving rTNSS and rTOSS,the SUCRA values ranking from highest to lowest were AF,FP,FF,and placebo.Improvements in rTNSS and rTOSS with FP,FF,and AF were all significantly greater than those observed with placebo,with AF demonstrating superior efficacy compared to both FP and FF.No statistically significant difference in rTNSS improvement was found between FP and FF,although FP exhibited significantly greater improvement in rTOSS compared to FF.CONCLUSION In adult patients with SAR,the combination of azelastine and fluticasone shows a significant effect in improving nasal and ocular symptoms,with FP demonstrating marked improvement in ocular symptoms compared to FF.展开更多
文摘BACKGROUND While the efficacy of medications such as fluticasone furoate(FF),fluticasone propionate(FP),and azelastine-fluticasone(AF)has been substantiated in comparison to their respective placebo controls,uncertainties persist regarding the comparative effectiveness of different intranasal agents.AIM To evaluate the efficacy of FP,FF,and AF in the treatment of adult patients with seasonal allergic rhinitis(SAR)using a meta-analytic approach.METHODS A computer search was conducted in Cochrane Library,PubMed,and EMBASE databases to identify randomized controlled trials assessing the effectiveness and safety of FF,FP,and AF in treating SAR.Data on treatment safety and efficacy were extracted and analyzed through meta-analysis.RESULTS A total of 20 studies were included,comprising 10590 participants.The results of the direct meta-analysis indicated that,compared to placebo,both relative Total Nasal Symptom Score(rTNSS)and relative Total Ocular Symptom Score(rTOSS)significantly decreased post-intervention[mean difference(MD)=-1.48,95%confidence interval(CI):-1.73 to-1.22;MD=-0.66,95%CI:-0.82 to-0.49],with similar findings observed across the FF,FP,and AF subgroups.The network meta-analysis results showed that for improving rTNSS and rTOSS,the SUCRA values ranking from highest to lowest were AF,FP,FF,and placebo.Improvements in rTNSS and rTOSS with FP,FF,and AF were all significantly greater than those observed with placebo,with AF demonstrating superior efficacy compared to both FP and FF.No statistically significant difference in rTNSS improvement was found between FP and FF,although FP exhibited significantly greater improvement in rTOSS compared to FF.CONCLUSION In adult patients with SAR,the combination of azelastine and fluticasone shows a significant effect in improving nasal and ocular symptoms,with FP demonstrating marked improvement in ocular symptoms compared to FF.
