Efficacy of different probiotic regimens for allergic rhinitis: A network meta-analysis

To evaluate the efficacy of different probiotic species in the treatment of Allergic rhinitis (AR), we used network meta-analysis (NMA), which provides a foundation for evidence-based therapeutic selection.

Nine databases were searched from their inception until April 30, 2024. Stata 17.0 and Review Manager 5.4 were used to conduct the NMA. The main outcomes included total nasal symptom score (TNSS), Rhinitis Quality of Life (RQLQ) global scores, total and specific IgE levels, blood eosinophil count, efficacy rate, and adverse events.

31 randomized controlled trials (RCTs) were included, involving 2544 patients with AR. In the NMA, in terms of reducing TNSS: Saccharomyces > Mix > Bifidobacterium > Enterococcus faecalis > Lactobacillus > Bacillus > conventional therapy; in terms of reducing RQLQ: Mix > Lactobacillus > Enterococcus faecalis > conventional therapy; in terms of reducing Total IgE: Mix > Bifidobacterium > Lactobacillus > Tetragenococcus halophilus > conventional therapy; in terms of reducing Special IgE: Mix > conventional therapy > Bifidobacterium > Lactobacillus > Leuconostoc; in terms of reducing blood eosinophil count: Lactobacillus > conventional therapy > Mix; in terms of improving the efficacy rate: Saccharomyces > Mix > conventional therapy. No serious adverse events were reported regarding safety.

Probiotic mixtures may be the most effective in reducing RQLQ, Total IgE, and Special IgE; Saccharomyces may be the most efficacious in reducing TNSS and improving the efficacy rate; and Lactobacillus may be the most effective in reducing blood eosinophil count. Overall, probiotic mixtures demonstrated better combined efficacy.