Nasal corticosteroids are a safe and effective treatment option for both allergic and non-allergic rhinitis. There are currently 8 different nasal corticosteroid preparations on the U.S. market. The nasal sprays differ with respect to delivery device and propellant, as well as potency and dosing frequency. The purpose of this review is evaluating the comparative evidence on the benefits and harms of the nasal corticosteroids to help policy makers and clinicians make informed choices.

Contents

• Introduction
  • Scope and Key Questions
• Methods
  • Literature Search
  • Study Selection
  • Data Abstraction
  • Quality Assessment
  • Evidence Synthesis
• Results
  • Overall results of literature search
  • Overall summary of the evidence
  • Detailed assessment: Key Question 1. For adults and children with seasonal or perennial (allergic and non-allergic) rhinitis, do nasal corticosteroids differ in effectiveness?
  • Key Question 2. For adults and children with seasonal or perennial (allergic and non-allergic) rhinitis, do nasal corticosteroids differ in safety or adverse events?
  • Key Question 3. Are there subgroups of patients based on demographics (age, racial groups, gender), other medications, or comorbidities, or in pregnancy and lactation for which one nasal corticosteroid is more effective or associated with fewer adverse events?
• Summary
• References
• Appendix A. Search strategies
• Appendix B. Quality criteria
• Appendix C. Results of literature search
• Appendix D. Listing of excluded studies
• Appendix E. Adverse effects in head-to-head trials
• Evidence Tables

Marian McDonagh, PharmD, Principal Investigator, Drug Effectiveness Review Project

Washington State Preferred Drug Program selected the topic, had input into the Key Questions, and funded this review. The content and conclusions of the review are entirely determined by the Evidence-based Practice Center researchers. The authors of this report have no financial interest in any company that makes or distributes the products reviewed in this report.

Suggested citation:

Selover D, Dana T, Smith C, Peterson, K. Drug class review on nasal corticosteroids. Update #1 final report. 2008.

The Agency for Healthcare Research and Quality has not yet seen or approved this report.

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.