Meta-analysis of azelastine nasal spray for the treatment of allergic rhinitis.
OBJECTIVE
To systematically review the efficacy of azelastine nasal spray for the treatment of allergic rhinitis.


METHODS
Meta-analysis of published randomized controlled trials reported in English.


METHODS
Published literature from the PubMed-MEDLINE database.


METHODS
Patients aged at least 12 (United States) or 16 years (Europe) with allergic rhinitis or nonallergic vasomotor rhinitis.


RESULTS
A global assessment of efficacy was used to estimate the number needed to treat for azelastine nasal spray compared with placebo or active comparators. The total symptom score was used to compare the effect size between azelastine and placebo. In five comparisons of azelastine and placebo, azelastine was most efficacious, with a summary number needed to treat of 5.0 (95% confidence interval [CI] 3.3-10.0). In reviewing 11 studies of azelastine versus active comparators, we found no significant difference between azelastine and active comparators (number needed to treat 66.7, 95% CI 14.3 to infinity to 25). Azelastine was more efficacious than placebo in terms of total symptom score (effect size of 0.36, 95% CI 0.26-0.46).


CONCLUSIONS
Azelastine nasal spray was more efficacious than placebo in the treatment of allergic rhinitis. No significant differences were observed between azelastine and active comparators for the treatment of allergic rhinitis; however, when azelastine was compared with oral antihistamines as monotherapy, the trend favored azelastine. Because azelastine appears to be as efficacious as oral antihistamines, the choice of treatment for seasonal allergic rhinitis should depend on the patient's preference regarding the route of administration, adverse effects, and the cost of the drug.
Lee
Todd A
TA
Midwest Center for Health Services and Policy Research, Hines Veterans Affairs Hospital, Hines, Illinois, USA.
Pickard
A Simon
AS
D000281:Administration, Intranasal; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D006801:Humans; D017060:Patient Satisfaction; D010793:Phthalazines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D010793:Phthalazines; C020976:azelastine