Botulinum toxin for chronic rhinitis: A systematic review and meta-analysis

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Neurology

Background:

• Chronic rhinitis significantly impacts patient quality of life.
• Current standard therapies may not be effective for all patients.
• Botulinum toxin type A (BTX-A) is being explored as a novel treatment option.

Purpose of the Study:

• To systematically evaluate the efficacy and safety of BTX-A for chronic rhinitis.
• To compare BTX-A with placebo and active treatments.

Main Methods:

• Systematic literature search of MEDLINE, Scopus, and EMBASE.
• Inclusion of randomized controlled trials (RCTs) assessing BTX-A in allergic and/or nonallergic rhinitis.
• Outcomes included total nasal symptom scores (TNSS), quality of life (QOL), and adverse events.

Main Results:

• BTX-A improved TNSS compared to placebo up to 24 weeks (SMD -2.22, p < 0.01).
• No significant differences were observed when comparing BTX-A to active treatments (triamcinolone, ipratropium bromide, cetirizine) for short-term TNSS.
• BTX-A demonstrated long-term benefits over triamcinolone for TNSS and individual symptoms, with favorable safety compared to cetirizine.

Conclusions:

• BTX-A significantly improves TNSS and QOL in chronic rhinitis patients.
• Treatment benefits were observed up to 24 weeks post-injection.
• BTX-A is a safe and well-tolerated option for patients unresponsive to conventional therapies.