Publications

COCHRANE REVIEWS

Intranasal corticosteroids for non-allergic rhinitis.

Christine Segboer, Artur Gevorgyan, Klementina Avdeeva, Supinda Chusakul, Jesada Kanjanaumporn, Songklot Aeumjaturapat, Laurens F Reeskamp, Kornkiat Snidvongs, Wytske Fokkens

Review question

We wanted to find out whether intranasal corticosteroids (steroids applied into the nose) are effective for the treatment of rhinitis that is not caused by allergy.

Key results

Intranasal corticosteroids compared with placebo

It is uncertain whether intranasal corticosteroids reduce patient‐reported disease severity in non‐allergic rhinitis patients compared with placebo when measured at up to three months. They may improve patient‐reported disease severity compared with placebo at up to four weeks, however this evidence is of low certainty. Treatment with intranasal corticosteroids probably increases the risk of epistaxis (nosebleed) but there is no difference in the risk of other adverse effects. It is not possible to tell from this review whether there is a difference between the different concentrations, delivery methods or treatment plans of intranasal corticosteroids. There are no good‐quality studies assessing changes in quality of life with intranasal corticosteroids.

Intranasal corticosteroids compared with other treatments

There is not enough evidence to know whether intranasal corticosteroid treatment is better, worse or the same as using other treatment strategies such as saline irrigation, intranasal antihistamines, capsaicin or ipratropium bromide for non‐allergic rhinitis.

Certainty of the evidence

Overall, the evidence for intranasal corticosteroids compared with placebo for most outcomes was either low‐certainty (our confidence in the effect estimate is low) or very low‐certainty (our confidence in the effect estimate is very low). This was because most studies were very small and used different methods to measure the same outcome. This evidence is up to date to July 2019.