Intranasal corticosteroid and oxymetazoline for chronic rhinitis: a systematic review

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Pharmacology

Background:

• Chronic rhinitis significantly impacts quality of life.
• Current treatments for chronic rhinitis have varying efficacy and side effect profiles.
• Combination therapy may offer enhanced symptom relief.

Purpose of the Study:

• To systematically review the evidence on the efficacy of combining intranasal corticosteroid spray with oxymetazoline hydrochloride nasal spray for chronic rhinitis.
• To compare the effectiveness of this combination therapy against monotherapy and placebo.

Main Methods:

• A systematic literature search was conducted across nine databases from inception to June 2020.
• The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Four randomized controlled trials involving 838 patients were included in the analysis.

Main Results:

• The combination of intranasal corticosteroid spray and oxymetazoline hydrochloride demonstrated superior improvement in nasal congestion compared to control groups.
• Patients receiving the combination therapy showed significantly increased nasal volume (15.8 ± 1.1 ml) versus placebo (12.1 ± 0.9 ml) or oxymetazoline hydrochloride alone (12.4 ± 0.8 ml).
• The observed improvements were statistically significant (p < .03 for combination vs. placebo/monotherapy; p = 0.003 for combination vs. monotherapy).

Conclusions:

• Combination treatment with intranasal corticosteroid spray and oxymetazoline hydrochloride appears more effective in reducing chronic rhinitis symptoms than either agent alone.
• This combination therapy may provide superior symptom relief without the risk of inducing rhinitis medicamentosa.
• Further research may support this combination as a valuable therapeutic option for chronic rhinitis management.