Systematic review and meta-analysis of adherence to intranasal corticosteroids and oral antihistamines in adults with allergic rhinitis
Photo by CDC / Unsplash
Key Takeaway
Note substantial geographic variation in adherence to intranasal corticosteroids and oral antihistamines in allergic rhinitis.
This systematic review and meta-analysis assessed adherence to intranasal corticosteroids and oral antihistamines in adults with allergic rhinitis. The analysis included 191,103 patients across multiple studies. Overall pooled adherence to these medications was 43%. Significant geographic variation was observed, with intranasal corticosteroid adherence at 17% in North America and 61% in Asia. Oral antihistamine adherence was 26% in North America and 48% in Northern and Western Europe.
The authors highlight substantial heterogeneity across studies and significant geographic variation in adherence rates. Self-reported adherence consistently exceeded pharmacy refill-based estimates in the included data. These measurement differences may influence the interpretation of real-world effectiveness.
Limitations include the inability to infer causation from observational adherence data and the need to avoid assuming clinical outcomes from adherence rates. The review does not report adverse events or discontinuations. Practice relevance is limited to using geographic stratification for benchmarks rather than universal targets.
More on Allergic Rhinitis
Montelukast and oral antihistamines improve daytime allergic rhinitis symptoms
Combination therapy beats single drug for daytime allergy symptoms
A meta-analysis finds combination therapy significantly improves daytime symptoms in allergic rhinitis, with limited benefits for nighttime …
Combining two common allergy drugs works better for daytime relief than taking just one, but the extra pill might not help you sleep at nigh…
Meta-analysis on SPG acupuncture for allergic rhinitis quality of life and symptom scores
Acupuncture at a Facial Nerve Point Eases Allergy Symptoms and Improves Life Quality
This meta-analysis of 732 patients with allergic rhinitis found that sphenopalatine ganglion acupuncture improved quality of life and nasal …
Acupuncture near a facial nerve bundle eases allergy symptoms and improves daily life for people with allergic rhinitis.
Systematic review and meta-analysis links swimming pool attendance to increased asthma risk in children
Swimming Pool Time May Raise Asthma Risk For Kids
This systematic review and meta-analysis evaluated the association between swimming pool attendance and the risk of allergic diseases in 54,…
New research shows swimming pool attendance may increase asthma risk for children but does not appear to affect other common allergies.
Systematic review on allergic rhinitis links environmental exposures and microbiome changes
Researchers find environment and microbes shape allergy risk
This systematic review synthesizes evidence on environmental exposures and the microbiome in allergic rhinitis.
Air pollution, early antibiotics, and farm life may change your nasal microbes, raising or lowering allergy risk, a new review suggests.
View Original Abstract ↓
PURPOSE OF REVIEW: Medication adherence is essential for effective management of allergic rhinitis (AR), yet real-world adherence to guideline-recommended pharmacotherapies remains poorly characterized. This systematic review and meta-analysis aims to estimate pooled adherence proportions to prescribed intranasal corticosteroids and oral antihistamines in adults with AR, further stratified by adherence measurement method and geographic region.
RECENT FINDINGS: Twelve studies encompassing 191,103 AR patients were included. Overall pooled adherence to both intranasal corticosteroids and oral antihistamines was 43%, with substantial heterogeneity across studies. Adherence estimates differed significantly by measurement method with self-reported adherence consistently exceeding pharmacy refill-based estimates for both medication classes. Significant geographic variation was also observed, with intranasal corticosteroid adherence ranging from 17% in North America to 61% in Asia, and oral antihistamine adherence ranging from 26% in North America to 48% in Northern and Western Europe. Peters' test did not indicate any significant publication bias and a Leave-One-Out (LOO) sensitivity analysis showed that no single study had a disproportionate effect on the overall effect size. Adherence to pharmacotherapy in AR is suboptimal, highly method-dependent, and varies significantly across geographic regions. These findings suggest that reported adherence rates are not only influenced by patients' behaviour, but also by the methods used to measure adherence and the broader healthcare environment. Integrating methodological rigour with geographic stratification provides more informative benchmarks for clinical practice and highlights the need for context-sensitive strategies to improve real-world AR management. Future research should prioritize standardized adherence measurement and prospective studies in underrepresented regions.
Budesonide-glycopyrronium-formoterol fumarate dihydrate improved lung function and reduced severe exacerbations versus budesonide-formoterol in inadequately controlled asthma
New Asthma Drug Cuts Attacks Without Recent Crisis
Related in Allergy & Immunology
Bayesian network meta-analysis of first-line immunotherapy versus TKI for advanced hepatocellular carcinoma
Immunotherapy Outperforms Standard Care for Advanced Liver Cancer
This Bayesian network meta-analysis of 7,301 patients with advanced hepatocellular carcinoma synthesized evidence from randomized trials. It…
A new analysis of 10 clinical trials shows that immunotherapy drugs help people with advanced liver cancer live longer than standard treatme…
Case report and review: azacytidine plus ruxolitinib in connective tissue disease with CMML and myelofibrosis
A single patient found relief from blood cancer with a new drug combo
This case report and literature review describes a 52-year-old male with connective tissue disease, chronic myelomonocytic leukemia, and mye…
One man with blood cancer saw his fever and anemia improve after two years on a specific drug mix, offering a glimpse into potential new tre…
Review of methionine manipulation in solid tumor immunotherapy settings
Doctors explore changing methionine levels to help immune cells fight solid tumors better
This narrative review examines the role of therapeutic manipulation of methionine availability, GCN2 signaling, and reactive oxygen species …
This review looks at how changing methionine availability might help immune cells work harder against solid tumors. It focuses on specific s…
Review of Chinese yam polysaccharides highlights safety gaps and need for further research
Chinese yam polysaccharides may boost immune balance through specific chemical structures
This narrative review examines Chinese yam polysaccharides (CYPs) as potential immunomodulatory agents. The authors note significant limitat…
New research shows how specific sugars in Chinese yam talk to your immune system to balance inflammation and fight infection
From Other Specialties
Meta-analysis links BMI polygenic scores to BMI in Filipino youth with double burden of malnutrition
Your Genes Affect Weight Differently If You're a Boy or Girl
This meta-analysis of cross-sectional data examined associations between BMI-related polygenic scores (PGSs) and anthropometric measures in …
• Genetic scores predict body fat better in Filipino boys than girls • Helps doctors understand childhood malnutrition in vulnerable communi…
FDA approves ticagrelor for multiple indications in cardiology and neurology
Brilinta Now Approved for Stroke Prevention in Three Key Groups
The FDA approved ticagrelor (Brilinta) for patients with ACS, CAD at high risk, and acute ischemic stroke or high-risk TIA. In ACS, it was s…
A widely used heart medication now has FDA approval to prevent first strokes in people with diabetes and to protect against repeat strokes a…
FDA Approves Sodium Thiosulfate Injection for Acute Cyanide Poisoning
FDA approves new treatment for cyanide poisoning emergencies
The FDA approved Sodium Thiosulfate Injection for sequential use with sodium nitrite for treatment of acute cyanide poisoning that is seriou…
The FDA approved Sodium Thiosulfate Injection for treating serious cyanide poisoning. It is used with another drug and supportive care. This…
FDA Approves Siliq (brodalumab) for Moderate to Severe Plaque Psoriasis
FDA approves new drug Siliq for adults with plaque psoriasis
The FDA approved Siliq (brodalumab) for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or photother…
The FDA approved Siliq (brodalumab) for adults with moderate to severe plaque psoriasis who have not responded well to other treatments. Thi…