Ipratropium Bromide Nasal Spray in Non-Allergic Rhinitis: A Systematic Review and Meta-Analysis.

Area of Science:

• Otorhinolaryngology
• Pharmacology

Background:

• Non-allergic rhinitis (NAR) presents significant challenges in symptom management, particularly rhinorrhea.
• Current treatment options for NAR often have limitations in efficacy and patient-reported outcomes.

Approach:

• A systematic review and meta-analysis was performed, including randomized controlled trials and non-randomized comparative parallel group trials.
• Searches were conducted across major medical literature databases (Medline, Embase, Cochrane).
• Five RCTs involving 472 participants with NAR were analyzed to compare intranasal ipratropium bromide (INIB) with placebo.

Key Points:

• INIB (0.03% nasal spray) demonstrated a significant reduction in rhinorrhea severity (SMD 0.93) and duration (SMD 0.35) compared to placebo.
• Symptom improvement was observed within the first week and maintained throughout treatment.
• Patients receiving INIB reported substantial improvements in physical and mental quality of life outcomes.

Conclusions:

• Intranasal ipratropium bromide is a safe and effective treatment for rhinorrhea in non-allergic rhinitis.
• INIB provides significant relief from nasal symptoms, enhancing both patient and physician-reported outcomes.
• The treatment leads to a notable improvement in the overall quality of life for individuals with NAR.