Efficacy of Mometasone Furoate Nasal Spray in the Treatment of Allergic Rhinitis. Meta-analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical Trials

Allergy. 2008 Oct;63(10):1280-91. doi: 10.1111/j.1398-9995.2008.01808.x. Epub 2008 Aug 21.

Abstract

Rationale: Several randomized, double-blind, placebo-controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta-analysis to determine the overall treatment effect.

Methods: A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double-blind, placebo-controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non-nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta-analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software.

Data synthesis: Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD -0.49, 95% CI: -0.60 to -0.38; P < 0.00001; I(2) = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (-0.41; 95% CI: -0.56 to -0.27), rhinorrhoea (-0.44; 95% CI: -0.66 to -0.21), sneezing (-0.40; 95% CI: -0.57 to -0.23) and nasal itching (-0.39; 95% CI: -0.53 to -0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (-0.30; 95% CI: -0.43 to -0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81-1.20; P = 0.91).

Conclusions: This meta-analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Intranasal
  • Anti-Allergic Agents / administration & dosage*
  • Anti-Allergic Agents / adverse effects
  • Anti-Allergic Agents / therapeutic use*
  • Double-Blind Method
  • Humans
  • Mometasone Furoate
  • Placebos
  • Pregnadienediols / administration & dosage*
  • Pregnadienediols / adverse effects
  • Pregnadienediols / therapeutic use*
  • Randomized Controlled Trials as Topic* / methods
  • Rhinitis, Allergic, Perennial / drug therapy*
  • Rhinitis, Allergic, Seasonal / drug therapy*

Substances

  • Anti-Allergic Agents
  • Placebos
  • Pregnadienediols
  • Mometasone Furoate