Nasal medications are effective for managing allergic rhinitis in children
Published online July 14, 2025
Allergic rhinitis is a common and impactful disease in children. In fact, previous studies have found that allergic rhinitis can have a negative impact on the academic performance of school children. However, there is a relative lack of evidence on the efficacy and safety of rhinitis treatments in children.
Considering this lack of systematized evidence on rhinitis medication children, Gil-Mata et al. performed a systematic review and network meta-analysis to compare the efficacy and safety of different classes of rhinitis nasal treatments in children. That systematic review, which was published in The Journal of Allergy and Clinical Immunology: In Practice, included all pediatric randomized controlled trials evaluating intranasal corticosteroids, intranasal antihistamines and fixed combinations of intranasal antihistamines + corticosteroids. A network meta-analysis approach was used to analyze data so that the authors were able to indirectly compare medication classes that had never been directly compared in head-to-head randomized controlled trials.
The systematic review included a total of 31 different studies, which assessed more than 12,000 participants. All classes of nasal treatments were found to be more effective than placebo in improving nasal symptoms. In children with seasonal allergic rhinitis, fixed combinations or intranasal antihistamines + corticosteroids were more effective in improving ocular symptoms and quality of life than intranasal corticosteroids. On the other hand, all treatment classes were similar in terms of their safety profile and none of them was associated with a higher risk of adverse events than placebo. Serious adverse events were rare and none of them were considered related to the treatment. Overall, this points to the effectiveness and safety of nasal treatments to manage allergic rhinitis in children.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
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